Epc, LLC

Primary specialty

Endoscopy Clinic/CenterTaxonomy code 261QE0800X

License

3301220R Issued in NY

Legal business name

EPC, LLC

Practice address

260 Township Blvd Ste 10
Camillus, NY 13031-1677

Phone

(315) 488-3905

Fax

(315) 488-2301

NPI assigned

Oct 2, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Elizabeth M. Wood, RN MBA CASC

Title

Administrator

Phone

(315) 488-2538

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Listed as

Endoscopic Procedure Center LLCCCN 33C0001086

Medicare certification status

ActiveFrom the Provider of Services file

Member of 3

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

• Associated Gastroenterologists of Central New York, PC

  • Gastroenterology Physician
  • Camillus, NY
  • NPI 1013938174

  Member Of

  NPD member
• Colon Rectal Associates of Central New York, LLP

  • Surgery Physician
  • East Syracuse, NY
  • NPI 1730248022

  Member Of

  NPD member
• Suny Health Science Center at Syracuse

  • Community/Retail Pharmacy
  • Syracuse, NY
  • NPI 1740796697

  Member Of

  NPD member

Locations

Practitioners 1

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

• John A Dale, MD

  • Gastroenterology Physician
  • Camillus, NY
  • NPI 1467475715
  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1811080963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 TOWNSHIP BLVD STE 10",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130311677",
            "telephone_number": "315-488-3905",
            "fax_number": "315-488-2301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 TOWNSHIP BLVD STE 10",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130311677",
            "telephone_number": "315-488-3905",
            "fax_number": "315-488-2301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4900 Broad Road",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "13215",
            "country_code": "US",
            "telephone_number": "315-492-5761",
            "fax_number": "315-492-5757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EPC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "315-488-2538",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN MBA CASC"
    },
    "taxonomies": [
        {
            "code": "261QE0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Endoscopy",
            "state": "NY",
            "license": "3301220R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02772287",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Justin Robert Edwards, OPTICIAN
• Emerging Vision Inc
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• Ashley Engelbrecht, RN
• Marc Darren Engle, D.D.S.
• Fairmount Family Medicine PLLC
• Anne Marie G Fallon, D.D.S.
• Michael William Fallon III, D.D.S.
• Familycare Medical Group PC
• Donna H Farchione, M.S., CCC-SLP, LMFT

• Endoscopy Clinic/Center in Camillus, NY
• Providers in Camillus, NY by specialty
• Endoscopy Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.