NPIMap

Organization Active NPI

Essex Endoscopy Center LLC

  • Ambulatory Surgical Clinic/Center
  • Newark, NJ
National Provider Identifier
1891701611
Registry record updated Sep 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
22810 Issued in NJ
Legal business name
ESSEX ENDOSCOPY CENTER LLC
Practice address
275 Chestnut St
Newark, NJ 07105-1570
Phone
(973) 589-5545
Fax
(973) 589-0073
NPI assigned
Aug 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2022

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

Authorized official

Name
Jeffrey E. Snodgrass
Title
President
Phone
(615) 665-1283

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 22810 NJ Primary

Addresses

Primary practice location

275 Chestnut St
Newark, NJ 07105-1570

Mailing address

1A Burton Hills Blvd.
Attn: L&C
Nashville, TN 37215-6187
Phone (615) 665-1283

Other identifiers 2

IdentifierTypeStateIssuer
9035303MedicaidNJ
0252468MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110420000284 NJ Part B Supplier - Ambulatory Surgical Center 1759566631 Practice locations: Newark, NJ

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Essex Endoscopy Center of NJ LLCCCN 31C0001148
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D1000463Essex Endoscopy Center LLC275 Chestnut Street, Newark, NJ 07105Certificate of waiverJun 16, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664150400000",
    "number": "1891701611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1A BURTON HILLS BLVD.",
            "address_2": "ATTN: L&C",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372156187",
            "telephone_number": "615-665-1283",
            "fax_number": "615-234-1720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 CHESTNUT ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071051570",
            "telephone_number": "973-589-5545",
            "fax_number": "973-589-0073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESSEX ENDOSCOPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-01",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A",
        "authorized_official_last_name": "SNODGRASS",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-665-1283"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NJ",
            "license": "22810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9035303",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0252468",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2022; 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.