St. Vrain Endoscopy Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

162 Issued in CO

Legal business name

ST. VRAIN ENDOSCOPY CENTER LLC

Practice address

1551 Professional LN
Suite 295
Longmont, CO 80501-6972

Phone

(303) 702-5900

Fax

(720) 890-0502

NPI assigned

Jun 25, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Peter S. Kaye, M.D., F.A.C.G.NPI 1114946639

Title

Managing Partner

Phone

(720) 932-7713

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Peter S Kaye, M.D., F.A.C.G.

  • Gastroenterology Physician
  • Boulder, CO
  • NPI 1114946639
  NPD (past) Authorized official

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210896000000",
    "number": "1801822341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "382 S ARTHUR AVE",
            "city": "LOUISVILLE",
            "state": "CO",
            "postal_code": "800273094",
            "telephone_number": "720-932-7713",
            "fax_number": "720-890-0502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 PROFESSIONAL LN",
            "address_2": "SUITE 295",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805016972",
            "telephone_number": "303-702-5900",
            "fax_number": "720-890-0502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. VRAIN ENDOSCOPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2008-05-16",
        "status": "A",
        "authorized_official_last_name": "KAYE",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "720-932-7713",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., F.A.C.G."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CO",
            "license": "162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00128204",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08677344",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "ST66577",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Squire Oral, Facial & Dental Implant Surgery
• SSC Longmont Operating Company LLC
• SSC Longmont Operating Company LLC
• St. Vincent General Hospital District
• St. Vincent General Hospital District
• St. Vrain OB-GYN Associates, P.C.
• St. Vrain Surgical Assists, LLC
• St. Vrain Valley School District Re-1J
• Tricia Staatz, FNP
• Stacy Ruse Counseling PLLC

• Ambulatory Surgical Clinic/Center in Longmont, CO
• Providers in Longmont, CO by specialty
• Ambulatory Surgical Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.