NPIMap

Organization Active NPI

Essex Specialized Surgical Institute LLC

  • Ambulatory Surgical Clinic/Center
  • West Orange, NJ
National Provider Identifier
1679728901
Registry record updated Jul 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
ESSEX SPECIALIZED SURGICAL INSTITUTE LLC
Practice address
475 Prospect Ave
West Orange, NJ 07052-4197
Phone
(732) 750-0400
Fax
(732) 750-1507
NPI assigned
Dec 1, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2010

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

Authorized official

Name
Dr. Christopher Quinn, OD
Title
President
Phone
(732) 750-0400

Specialties & licenses 1

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

Addresses

Primary practice location

475 Prospect Ave
West Orange, NJ 07052-4197

Mailing address

562 Easton Ave
Somerset, NJ 08873-1900
Phone (732) 846-2501

Other identifiers 1

IdentifierTypeStateIssuer
0206733MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090424000141 NJ Part B Supplier - Ambulatory Surgical Center 4385792670 Practice locations: West Orange, NJ

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Essex Specialized Surgical InstituteCCN 31C0001156
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
31D1094771Essex Specialized Surgical Institute475 Prospect Avenue, West Orange, NJ 07052Certificate of waiverJan 26, 2027

National Provider Directory

National Provider Directory

Member of 4

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

Practitioners & affiliated clinicians

Practitioners 11

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

NPI Registry JSON

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

{
    "created_epoch": "1228089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280361600000",
    "number": "1679728901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "562 EASTON AVE",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088731900",
            "telephone_number": "732-846-2501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 PROSPECT AVE",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070524197",
            "telephone_number": "732-750-0400",
            "fax_number": "732-750-1507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESSEX SPECIALIZED SURGICAL INSTITUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-01",
        "last_updated": "2010-07-29",
        "status": "A",
        "authorized_official_last_name": "QUINN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-750-0400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0206733",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Orange, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2010; 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.