Central Coast Endoscopy Center Inc

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

CENTRAL COAST ENDOSCOPY CENTER INC

Practice address

243 Green Valley Rd Ste F
Freedom, CA 95019-3133

Phone

(831) 763-0407

Fax

(831) 763-0101

NPI assigned

Jun 9, 2006

Last updated

Feb 7, 2023By 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

Steven G Johnson, MDNPI 1265439038

Title

Director

Phone

(831) 800-7887

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Listed as

Central Coast Endoscopy Center IncCCN 05C0001396

Medicare certification status

ActiveFrom the Provider of Services file

Listed as

Central Coast Endoscopy Center IncCCN 55C0001128

Medicare certification status

ActiveFrom the Provider of Services file

Locations

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.

• Steven G Johnson, M.D

  • Gastroenterology Physician
  • Salinas, CA
  • NPI 1265439038
  NPD Authorized official

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675728000000",
    "number": "1760423180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1081 LOS PALOS DR",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "939013916",
            "telephone_number": "831-763-0407",
            "fax_number": "831-763-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 GREEN VALLEY RD STE F",
            "city": "FREEDOM",
            "state": "CA",
            "postal_code": "950193133",
            "telephone_number": "831-763-0407",
            "fax_number": "831-763-0101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1081 Los Palos Dr",
            "address_purpose": "LOCATION",
            "city": "Salinas",
            "state": "CA",
            "postal_code": "939013916",
            "country_code": "US",
            "telephone_number": "831-424-8888",
            "fax_number": "831-783-3089",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CENTRAL COAST ENDOSCOPY CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "831-800-7887",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "B/SHIELD PROVIDER #",
            "identifier": "ZZZH4400Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER #",
            "identifier": "051396- 001",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SUR01396F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Baskerville, Bennett, Block & Liu, a Medical Corp (Capitola Pediatrics)
• Lawrence A Birndorf, MD
• Edward Bradbury, M.D.
• Jose Bugay, D.P.T.
• George Pardue Bunch, MD
• Dennis James Chamberlain, MD
• Aimee C. Chang, MD
• Peilin Chang, MD
• Frederick Wen Kang Chen, MD
• Siyi Chen, PHARM. D

• Ambulatory Surgical Clinic/Center in Freedom, CA
• Providers in Freedom, 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 Feb 7, 2023; 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.