Puget Sound Gastroenterology, PLLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

PUGET SOUND GASTROENTEROLOGY, PLLC

Doing business as

Edmonds Endoscopy Center

Practice address

21600 Hwy 99
Suite 260
Edmonds, WA 98026-8012

Phone

(425) 774-2650

Fax

(425) 774-2643

NPI assigned

Jul 16, 2006

Last updated

May 16, 2025By 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

Alan Oliver, CEO

Title

Ceo

Phone

(786) 530-3820

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Edmonds Endoscopy Center Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Puget Sound Gastroenterology, PLLC

  dba Puget Sound Gastroenterology at Edmonds

  • Gastroenterology Physician
  • Edmonds, WA
  • NPI 1033132956

  O20040301000478

  Same enrollment
• Puget Sound Gastroenterology, PLLC

  • Gastroenterology Physician
  • Olympia, WA
  • NPI 1386340164

  O20040301000478

  Same enrollment
• Puget Sound Gastroenterology, PLLC

  dba Puget Sound Gastroenterology at Kirkland

  • Gastroenterology Physician
  • Kirkland, WA
  • NPI 1427185388

  O20040301000478

  Same enrollment
• Puget Sound Gastroenterology, PLLC

  dba Seattle Gastroenterology Associates

  • Gastroenterology Physician
  • Seattle, WA
  • NPI 1649212606

  O20040301000478

  Same enrollment
• Puget Sound Gastroenterology, PLLC

  dba PSG Division of Pathology

  • Clinical Medical Laboratory
  • Lynnwood, WA
  • NPI 1689646838

  O20040301000478

  Same enrollment
• Puget Sound Gastroenterology, PLLC

  • Gastroenterology Physician
  • Mill Creek, WA
  • NPI 1912929738

  O20040301000478

  Same enrollment

Listed as

Edmonds Endoscopy CenterCCN 50C0001157

Medicare certification status

ActiveFrom the Provider of Services file

Locations

Practitioners 1

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.

• Michael Kandil, PA-C

  • Physician Assistant
  • Seattle, WA
  • NPI 1548858574
  NPD (past)

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747353600000",
    "number": "1811914625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34888",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241888",
            "telephone_number": "425-977-4620",
            "fax_number": "425-745-9836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21600 HWY 99",
            "address_2": "SUITE 260",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980268012",
            "telephone_number": "425-774-2650",
            "fax_number": "425-774-2643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUGET SOUND GASTROENTEROLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A",
        "authorized_official_last_name": "OLIVER",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "786-530-3820",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "8906971",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1045755",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edmonds Endoscopy Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Edmonds Endoscopy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Public Hospital District 2 of Snohomish County (Birth & Family Clinic)
• Puget Sound Dermatology, PLLC
• Puget Sound Family Physicians
• Puget Sound Gastroenterology, PLLC (Puget Sound Gastroenterology at Edmonds)
• Puget Sound Gastroenterology, PLLC
• Puget Sound Medical Associates LLC
• Puget Sound Neurology
• Puget Sound Otolaryngology Inc PS (Puget Sound Surgicenter)
• Chetan Pungoti, MD
• Siera Victoria Purcell, M.T.

• Ambulatory Surgical Clinic/Center in Edmonds, WA
• Providers in Edmonds, WA by specialty
• Ambulatory Surgical Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2025; 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.