NPIMap

Organization Active NPI

San Mateo Endoscopy Center

Doing business as Mid Peninsula Endoscopy Center

  • Ambulatory Surgical Clinic/Center
  • San Mateo, CA
National Provider Identifier
1689634891
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
SAN MATEO ENDOSCOPY CENTER
Doing business as
Mid Peninsula Endoscopy Center
Practice address
50 S San Mateo Dr
# 400
San Mateo, CA 94401-3857
Phone
(650) 579-7082
Fax
(650) 579-7743
NPI assigned
Mar 23, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Michael Mainardi, M.D.
Title
Medical Director
Phone
(650) 340-9977

Specialties & licenses 1

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

Addresses

Primary practice location

50 S San Mateo Dr
# 400
San Mateo, CA 94401-3857

Mailing address

50 S. San Mateo Dr.
# 400
San Mateo, CA 94401-3861
Phone (650) 579-7082

Other identifiers 3

IdentifierTypeStateIssuer
SUR01370FMedicaidCA
051370OtherCABLUE CROSS ID
4422407OtherCACIGNA ID

Other names 1

  • Mid Peninsula Endoscopy Center Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689634891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 S. SAN MATEO DR.",
            "address_2": "# 400",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944013861",
            "telephone_number": "650-579-7082",
            "fax_number": "650-579-7743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 S SAN MATEO DR",
            "address_2": "# 400",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944013857",
            "telephone_number": "650-579-7082",
            "fax_number": "650-579-7743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN MATEO ENDOSCOPY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MAINARDI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "650-340-9977",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SUR01370F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS ID",
            "identifier": "051370",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA ID",
            "identifier": "4422407",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mid Peninsula Endoscopy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Mateo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.