Glastonbury Endoscopy Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

GLASTONBURY ENDOSCOPY CENTER, LLC

Practice address

300 Western Blvd
BLDG., D, Suite 100
Glastonbury, CT 06033-1236

Phone

(714) 843-5997

Fax

(714) 843-5907

NPI assigned

Nov 11, 2008

Last updated

May 9, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey Nestler, M.D.

Title

Medical Director

Phone

(860) 657-1950

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Listed as

Glastonbury Endoscopy CenterCCN 07C0001053

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Member of 2

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

• Connecticut Gi PLLC

  • Gastroenterology Physician
  • Hartford, CT
  • NPI 1023124625

  Member Of

  NPD member
• Hartford Hospital

  dba Hartford Healthcare Retail Pharmacy

  • Community/Retail Pharmacy
  • Hartford, CT
  • NPI 1790183515

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1226361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368057600000",
    "number": "1659525020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 WESTERN BLVD",
            "address_2": "BLDG., D, SUITE 100",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060331236",
            "telephone_number": "714-843-5997",
            "fax_number": "714-843-5907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 WESTERN BLVD",
            "address_2": "BLDG., D, SUITE 100",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060331236",
            "telephone_number": "714-843-5997",
            "fax_number": "714-843-5907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLASTONBURY ENDOSCOPY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-11",
        "last_updated": "2013-05-09",
        "status": "A",
        "authorized_official_last_name": "NESTLER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "860-657-1950",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Beth Glass, M.A.
• Glastonbury Acquisition Operator LLC
• Glastonbury Dental Associates LLP
• Glastonbury Dental Care
• Glastonbury Dental Group LLC
• Glastonbury Eye Care, LLC
• Glastonbury Family Dental
• Glastonbury Family Dental PC
• Glastonbury Family Medicine LLC
• Glastonbury Health Care Center Inc

• Ambulatory Surgical Clinic/Center in Glastonbury, CT
• Providers in Glastonbury, CT by specialty
• Ambulatory Surgical Clinic/Center in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2013; 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.