NPIMap

Organization Active NPI

Morris Avenue Endoscopy LLC

  • Ambulatory Surgical Clinic/Center
  • Mountainside, NJ
National Provider Identifier
1780747394
Registry record updated Sep 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
MORRIS AVENUE ENDOSCOPY LLC
Practice address
200 Sheffield St Ste 101
Mountainside, NJ 07092-2315
Phone
(908) 241-8900
Fax
(908) 241-8933
NPI assigned
Dec 18, 2006
Last updated
Sep 28, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2021

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

Authorized official

Name
Robert Greenblatt, MDNPI 1861580433
Title
Owner
Phone
(908) 241-8900

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
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

200 Sheffield St Ste 101
Mountainside, NJ 07092-2315

Mailing address

200 Sheffield St Ste 101
Mountainside, NJ 07092-2315
Phone (908) 241-8900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091211000007 NJ Part B Supplier - Ambulatory Surgical Center 8921074840 Receives reassigned benefits from 4 practitioners
Practice locations: Mountainside, NJ

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Garden State Endoscopy and Surgery CenterCCN 31C0001131
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Garden State Endoscopy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

200 Sheffield St
Ste 101
Mountainside, NJ 07092
Phone (908) 241-8900

Practitioners & affiliated clinicians

Practitioners 58

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.

View all 58

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632787200000",
    "number": "1780747394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 SHEFFIELD ST STE 101",
            "city": "MOUNTAINSIDE",
            "state": "NJ",
            "postal_code": "070922315",
            "telephone_number": "908-241-8900",
            "fax_number": "908-241-8933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SHEFFIELD ST STE 101",
            "city": "MOUNTAINSIDE",
            "state": "NJ",
            "postal_code": "070922315",
            "telephone_number": "908-241-8900",
            "fax_number": "908-241-8933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORRIS AVENUE ENDOSCOPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A",
        "authorized_official_last_name": "GREENBLATT",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-241-8900",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountainside, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2021; 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.