NPIMap

Organization Active NPI

Blue Ash Endoscopy Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Cincinnati, OH
National Provider Identifier
1649957168
Registry record updated Apr 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
BLUE ASH ENDOSCOPY CENTER, LLC
Practice address
11333 Cornell Park Dr
Cincinnati, OH 45242-1813
Phone
(513) 569-1355
NPI assigned
Jun 28, 2023
Last updated
Apr 24, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
GCGA PHYSICIANS LLC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 24, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Scott Montgomery
Title
Officer/Authorized Official
Phone
(615) 545-9132

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

11333 Cornell Park Dr
Cincinnati, OH 45242-1813

Mailing address

11333 Cornell Park Dr Ste 100
Blue Ash, OH 45242-1813

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231211003466 OH Part B Supplier - Ambulatory Surgical Center 5799134110 Practice locations: Blue Ash, OH

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Blue Ash Endoscopy Center LLCCCN 36C0001361
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2293244Blue Ash Endoscopy Center, LLC11333 Cornell Park Drive, Cincinnati, OH 45242Certificate of waiverNov 5, 2027

National Provider Directory

National Provider Directory
Part of
Gcga Physicians Cinti G

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

11333 Cornell Park Dr
Ste 100
Blue Ash, OH 45242
Phone (513) 569-1355

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1687910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776988800000",
    "number": "1649957168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11333 CORNELL PARK DR STE 100",
            "city": "BLUE ASH",
            "state": "OH",
            "postal_code": "452421813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11333 CORNELL PARK DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452421813",
            "telephone_number": "513-569-1355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE ASH ENDOSCOPY CENTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GCGA PHYSICIANS LLC.",
        "enumeration_date": "2023-06-28",
        "last_updated": "2026-04-24",
        "certification_date": "2026-04-24",
        "status": "A",
        "authorized_official_last_name": "MONTGOMERY",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "OFFICER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "615-545-9132"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.