Ventura Endoscopy Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

50000592 Issued in CA

Legal business name

VENTURA ENDOSCOPY CENTER LLC

Practice address

5810 Ralston Street
Suite 101
Ventura, CA 93003

Phone

(805) 650-5500

Fax

(805) 650-5505

NPI assigned

Sep 12, 2006

Last updated

Jul 11, 2011By 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

Tesu N Lin, MD

Title

Medical Director/CMS Authorized Off

Phone

(805) 641-6525

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Ventura Endoscopy Center LLCCCN 05C0001656

Medicare certification status

ActiveFrom the Provider of Services file

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Chetan Gondha, MD

  • Internal Medicine Physician
  • Ventura, CA
  • NPI 1992715155
  NPD (past)

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310342400000",
    "number": "1710081443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5810 RALSTON STREET",
            "address_2": "SUITE 101",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930036010",
            "telephone_number": "805-650-5500",
            "fax_number": "805-650-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5810 RALSTON STREET",
            "address_2": "SUITE 101",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "93003",
            "telephone_number": "805-650-5500",
            "fax_number": "805-650-5505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VENTURA ENDOSCOPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-12",
        "last_updated": "2011-07-11",
        "status": "A",
        "authorized_official_last_name": "LIN",
        "authorized_official_first_name": "TESU",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR/CMS AUTHORIZED OFF",
        "authorized_official_telephone_number": "805-641-6525",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "50000592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ventura Dental Specialty Group
• Ventura Dermatology Medical Clinic, Inc
• Ventura Diagnostic Laboratory
• Ventura Ear Nose & Throat Med Group Inc
• Ventura Emergency Physicians
• Ventura Endoscopy Center Partners LLC
• Ventura Eye Associates Inc
• Ventura Family Therapy Collective
• Ventura Grand Chateau, LLC
• Ventura Harbor Restaurant Associates Inc (Water's Edger Restaurant & Bar)

• Ambulatory Surgical Clinic/Center in Ventura, CA
• Providers in Ventura, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2011; 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.