St. Petersburg Endoscopy Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

14960618 Issued in FL

Legal business name

ST. PETERSBURG ENDOSCOPY CENTER LLC

Practice address

560 Jackson Street North
Suite 200
St. Petersburg, FL 33705-1449

Phone

(727) 820-7500

Fax

(727) 820-6333

NPI assigned

Aug 3, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Chetan K Desai, MDNPI 1982675526

Title

President

Phone

(727) 820-7500

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Listed as

St Petersburg Endoscopy Center LLCCCN 10C0001468

Medicare certification status

ActiveFrom the Provider of Services file

Networks

• Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)
• Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Maximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…

Practitioners 1

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

• Chetan K Desai, MD

  • Gastroenterology Physician
  • St Petersburg, FL
  • NPI 1982675526
  NPD (past) Authorized official

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348531200000",
    "number": "1689682247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 JACKSON STREET NORTH",
            "address_2": "SUITE 200",
            "city": "ST. PETERSBURG",
            "state": "FL",
            "postal_code": "337051449",
            "telephone_number": "727-820-7500",
            "fax_number": "727-820-6333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 JACKSON STREET NORTH",
            "address_2": "SUITE 200",
            "city": "ST. PETERSBURG",
            "state": "FL",
            "postal_code": "337051449",
            "telephone_number": "727-820-7500",
            "fax_number": "727-820-6333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. PETERSBURG ENDOSCOPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2012-09-25",
        "status": "A",
        "authorized_official_last_name": "DESAI",
        "authorized_official_first_name": "CHETAN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-820-7500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "FL",
            "license": "1247",
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "FL",
            "license": "14960618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "076202400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• St. Pete Therapy Center
• St. Petersburg Center for Performance and Weight Loss
• St. Petersburg Counseling, LLC
• St. Petersburg Dental Implant Center
• St. Petersburg Dermatology, LLC
• St. Petersburg Free Clinic
• St. Petersburg General Hospital
• St. Petersburg General Surgery LLC
• St. Petersburg Nursing and Rehabilitation, LLC
• St. Petersburg Nutrition LLC

• Ambulatory Surgical Clinic/Center in St. Petersburg, FL
• Providers in St. Petersburg, FL by specialty
• Ambulatory Surgical Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2012; 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.