Agcny East LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

PENDING Issued in NY

Legal business name

AGCNY EAST LLC

Doing business as

Endoscopy Center of Central New York

Practice address

Northeast Medical Building Condominium
Suite 308
Fayetteville, NY 13066-6638

Phone

(315) 329-7301

Fax

(315) 329-7302

NPI assigned

Oct 21, 2010

Last updated

May 14, 2019By 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

Laureen H Ascenzo

Title

Contact Person

Phone

(315) 708-0091

Specialties & licenses 1

Addresses

Other names 1

• Endoscopy Center of Central New York Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Listed as

Agcny East LLCCCN 33C0001113

Medicare certification status

ActiveFrom the Provider of Services file

Locations

Practitioners 2

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.

• Theodore Koh, MD

  • Gastroenterology Physician
  • Camillus, NY
  • NPI 1114931037
  NPD (past)
• John Sun, DO

  • Gastroenterology Physician
  • Camillus, NY
  • NPI 1205840899
  NPD (past)

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

{
    "created_epoch": "1287619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557792000000",
    "number": "1801196050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 TOWNSHIP BLVD STE 20",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130311678",
            "telephone_number": "315-708-0091",
            "fax_number": "315-708-0194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NORTHEAST MEDICAL BUILDING CONDOMINIUM",
            "address_2": "SUITE 308",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130666638",
            "telephone_number": "315-329-7301",
            "fax_number": "315-329-7302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGCNY EAST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-21",
        "last_updated": "2019-05-14",
        "status": "A",
        "authorized_official_last_name": "ASCENZO",
        "authorized_official_first_name": "LAUREEN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CONTACT PERSON",
        "authorized_official_telephone_number": "315-708-0091"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NY",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Endoscopy Center of Central New York",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Endoscopy Center of Central New York",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Katherine Abbey, RPH
• Fadi Nabil Abdallah, D.M.D.
• Ancy A. Abraham, PH.D.
• Advocates Incorporated
• Agcny Physicians PLLC
• Janette S Albrecht, M.D.
• Keith Alan Alexander, D.D.S.
• Alexis James Virtual Counseling
• Maureen Ann Aliani, OTR/L

• Ambulatory Surgical Clinic/Center in Fayetteville, NY
• Providers in Fayetteville, NY by specialty
• Ambulatory Surgical Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2019; 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.