Medical Center Endoscopy, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

0399 Issued in TX

Legal business name

MEDICAL CENTER ENDOSCOPY, LLC

Practice address

6560 Fannin St
Suite 600
Houston, TX 77030-2761

Phone

(713) 796-0500

Fax

(713) 797-1417

NPI assigned

Aug 13, 2006

Organization subpart

No

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

Authorized official

Name

Jennifer Boyd Baldock

Title

Officer and Authorized Official

Phone

(615) 234-5954

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• MEDICAL CENTER ENDOSCOPY Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Ambulatory surgical center certification: CCN 45C0451238

Legal name

MEDICAL CENTER ENDOSCOPY L L P

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Dec 4, 1998

Last certification

May 18, 2017

Ownership / control type

Proprietary

Facility address

6560 Fannin Suite 600
Houston, TX 77030

Listed as

Medical Center Endoscopy LLCCCN 45C0001238

Member of 2

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

• Medvest Inc

  • Community/Retail Pharmacy
  • Houston, TX
  • NPI 1740291236

  Member Of

  NPD member
• The Methodist Hospital

  • Community/Retail Pharmacy
  • Houston, TX
  • NPI 1073112272

  Member Of

  NPD member

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Steven Jay Frachtman, M.D.

  • Gastroenterology Physician
  • Houston, TX
  • NPI 1669618500
  NPD (past)

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668038400000",
    "number": "1679585772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6560 FANNIN ST",
            "address_2": "SUITE 600",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302761",
            "telephone_number": "713-796-0500",
            "fax_number": "713-797-1417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6560 FANNIN ST",
            "address_2": "SUITE 600",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302761",
            "telephone_number": "713-796-0500",
            "fax_number": "713-797-1417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL CENTER ENDOSCOPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-13",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A",
        "authorized_official_last_name": "BALDOCK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "BOYD",
        "authorized_official_title_or_position": "OFFICER AND AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "615-234-5954"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TX",
            "license": "0399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "ASC025",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER #",
            "identifier": "45C0001238",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDICAL CENTER ENDOSCOPY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MEDICAL CENTER ENDOSCOPY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ambulatory Surgical Clinic/Center in Houston, TX
• Providers in Houston, TX by specialty
• Ambulatory Surgical Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.