Endo Surgi Center of Old Bridge LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

ENDO SURGI CENTER OF OLD BRIDGE LLC

Practice address

42 Throckmorton LN
Old Bridge, NJ 08857-2572

Phone

(732) 679-8808

Fax

(732) 679-7280

NPI assigned

Sep 27, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Samiappan Muthusamy, MD

Title

Medical Director

Phone

(732) 679-8808

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Listed as

Endo Surgi Center of Old Bridge LLCCCN 31C0001091

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Virtua - West Jersey Health System, Inc.

  • Home Health Agency
  • Marlton, NJ
  • NPI 1316943004

  Member Of

  NPD member

Practitioners 1

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

• Brian Charles Katz, M.D.

  • Gastroenterology Physician
  • Highland Park, NJ
  • NPI 1538261136
  NPD

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298505600000",
    "number": "1801987805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 THROCKMORTON LN",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088572572",
            "telephone_number": "732-679-8808",
            "fax_number": "732-679-7280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 THROCKMORTON LN",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088572572",
            "telephone_number": "732-679-8808",
            "fax_number": "732-679-7280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDO SURGI CENTER OF OLD BRIDGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2011-02-24",
        "status": "A",
        "authorized_official_last_name": "MUTHUSAMY",
        "authorized_official_first_name": "SAMIAPPAN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "732-679-8808",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nicole Lynn Elvina, FNP-BC, FNP-C
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• Francesca Lynn Enriquez, LPC
• Enyacare
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• Catherine Eskander, LAMFT

• Ambulatory Surgical Clinic/Center in Old Bridge, NJ
• Providers in Old Bridge, NJ by specialty
• Ambulatory Surgical Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2011; 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.