Organization Active NPI

Tristar Endoscopy LLC

  • Anesthesiology Physician
  • Staten Island, NY
National Provider Identifier
1710554308
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
TRISTAR ENDOSCOPY LLC
Practice address
4277 Richmond Ave
Staten Island, NY 10312-6241
Phone
(718) 227-1282
NPI assigned
Jun 10, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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

Authorized official

Name
Dr. Anu Sampat, MDNPI 1437116076
Title
Owner
Phone
(718) 227-1282

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

4277 Richmond Ave
Staten Island, NY 10312-6241

Mailing address

10 White Rock Terrace
Holmdel, NJ 07733-1645
Phone (718) 227-1282

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210701001256 NY Part B Supplier - Clinic/Group Practice 5597166231 Receives reassigned benefits from 4 practitioners
Practice locations: Staten Island, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1623283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623283200000",
    "number": "1710554308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 WHITE ROCK TERRACE",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331645",
            "telephone_number": "718-227-1282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4277 RICHMOND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103126241",
            "telephone_number": "718-227-1282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRISTAR ENDOSCOPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-10",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A",
        "authorized_official_last_name": "SAMPAT",
        "authorized_official_first_name": "ANU",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-227-1282",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.