Center for Endoscopy LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

CENTER FOR ENDOSCOPY LLC

Practice address

3921 Waring Rd
Ste. B
Oceanside, CA 92056-4456

Phone

(760) 940-6300

Fax

(760) 940-8074

NPI assigned

Jul 16, 2014

Last updated

Oct 4, 2024By 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

Eric Boon

Title

Officer/Ao

Phone

(480) 567-0269

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Center for Endoscopy LLCCCN 05C0001204

Medicare certification status

ActiveFrom the Provider of Services file

Tax ID family

Center for Endoscopy LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Center for Endoscopy LLC

  • Ambulatory Surgical Clinic/Center
  • Oceanside, CA
  • NPI 1073939682
  NPD tax ID

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Comfort Endoscopy Anesthesia LLC

  • Certified Registered Nurse Anesthetist
  • Oceanside, CA
  • NPI 1417373028

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1405468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728000000000",
    "number": "1942617477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14201 DALLAS PKWY STE 600",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752542916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3921 WARING RD",
            "address_2": "STE. B",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920564456",
            "telephone_number": "760-940-6300",
            "fax_number": "760-940-8074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR ENDOSCOPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-16",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A",
        "authorized_official_last_name": "BOON",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "OFFICER/AO",
        "authorized_official_telephone_number": "480-567-0269"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kalvin Wang Caunan, DO
• Jenesa Cary Cazare
• Karen Stefanie Ceballos
• Puri Amanah Celes-Mendiola
• Center for Endoscopy LLC
• Center for Positive Changes (Center for Positive Changes 5)
• Center for Positive Changes Stay
• Cep America - Intensivists PC
• Skye A Cerda
• Caroline Cervantes

• Ambulatory Surgical Clinic/Center in Oceanside, CA
• Providers in Oceanside, 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 Oct 4, 2024; 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.