Main Line Endoscopy Center LLC

Primary specialty

Endoscopy Clinic/CenterTaxonomy code 261QE0800X

License

15801501 Issued in PA

Legal business name

MAIN LINE ENDOSCOPY CENTER LLC

Practice address

325 Central Ave
Malvern, PA 19355-3265

Phone

(610) 644-7274

Fax

(610) 644-7276

NPI assigned

Feb 28, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Christopher A Holden

Title

President of the General Partner

Phone

(615) 665-1283

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

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

• Main Line PA Endoscopy ASC LP

  • Ambulatory Surgical Clinic/Center
  • Malvern, PA
  • NPI 1023115078

  O20070328000378

  Same enrollment

Locations

Practitioners 3

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

• Matthew R. Astroff, M.D.

  • Gastroenterology Physician
  • Malvern, PA
  • NPI 1457327439
  NPD (past)
• Janson Jacob, MD

  • Gastroenterology Physician
  • Malvern, PA
  • NPI 1629638614
  NPD (past)
• Takahiro Ignacio Nakamura, MD

  • Gastroenterology Physician
  • Malvern, PA
  • NPI 1356831242
  NPD (past)

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198022400000",
    "number": "1871569780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 340",
            "city": "SELLERSVILLE",
            "state": "PA",
            "postal_code": "189600340",
            "telephone_number": "215-723-2333",
            "fax_number": "215-723-9112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 CENTRAL AVE",
            "city": "MALVERN",
            "state": "PA",
            "postal_code": "193553265",
            "telephone_number": "610-644-7274",
            "fax_number": "610-644-7276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN LINE ENDOSCOPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-28",
        "last_updated": "2007-12-19",
        "status": "A",
        "authorized_official_last_name": "HOLDEN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT OF THE GENERAL PARTNER",
        "authorized_official_telephone_number": "615-665-1283",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "PA",
            "license": "16701501",
            "primary": false
        },
        {
            "code": "261QE0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Endoscopy",
            "state": "PA",
            "license": "15801501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Clark Macaulay, D.C.
• Gina Macgillivray
• Archana Machavarapu, M.D.
• Susan Marie Madel, PT
• Magnotta Behavioral Health, LLC
• Main Line Gastroenterology Associates, PC
• Main Line Home Care Services LLC
• Main Line Hospitals, Inc.
• Main Line Neuropsychology, PLLC
• Main Line PA Endoscopy ASC LP

• Endoscopy Clinic/Center in Malvern, PA
• Providers in Malvern, PA by specialty
• Endoscopy Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.