Walnut Creek Endoscopy Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

WALNUT CREEK ENDOSCOPY CENTER LLC

Practice address

365 Lennon LN Ste 100
Walnut Creek, CA 94598-5911

Phone

(650) 331-4662

Fax

(866) 408-1090

NPI assigned

May 15, 2008

Last updated

May 16, 2008By 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

Samuel N Marcus, MD, PHD

Title

Co-Founder

Phone

(650) 331-4650

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Walnut Creek Endoscopy Center LLCCCN 05C0001886

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.

• Sutter Bay Medical Foundation

  dba Palo Alto Medical Foundation

  • Durable Medical Equipment & Medical Supplies
  • Los Gatos, CA
  • NPI 1518696459

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1210809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210896000000",
    "number": "1851568067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 DISTEL DR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221521",
            "telephone_number": "650-331-4650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 LENNON LN STE 100",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945985911",
            "telephone_number": "650-331-4662",
            "fax_number": "866-408-1090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALNUT CREEK ENDOSCOPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-15",
        "last_updated": "2008-05-16",
        "status": "A",
        "authorized_official_last_name": "MARCUS",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "CO-FOUNDER",
        "authorized_official_telephone_number": "650-331-4650",
        "authorized_official_credential": "MD, PHD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walnut Creek Audiology Corp
• Walnut Creek Community Healthcare, LLC (Rossmoor Post Acute)
• Walnut Creek DBT Psychology Clinic
• Walnut Creek Dentists Partnership
• Walnut Creek Elementary School District
• Walnut Creek Eye Medical Group, Inc
• Walnut Creek Heartscan, LLC
• Walnut Creek Medical Group
• Walnut Creek Modern Dentistry, Prof. Corp (Walnut Creek Modern Dentistry)
• Walnut Creek Modern Dentistry, Prof. Corp. (Walnut Creek Modern Dentistry)

• Ambulatory Surgical Clinic/Center in Walnut Creek, CA
• Providers in Walnut Creek, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• 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.
• 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.