Middlesex Endoscopy Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

MIDDLESEX ENDOSCOPY CENTER LLC

Practice address

410 Saybrook Rd
Suite 200
Middletown, CT 06457-4777

Phone

(860) 343-1240

Fax

(860) 343-1250

NPI assigned

Jul 19, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Kris Mineau

Title

Administrator

Phone

(860) 665-0174

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Listed as

Middlesex Endoscopy Center LLCCCN 07C0001042

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

Practitioners 1

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

• Gregor J Koobatian, MD

  • Gastroenterology Physician
  • Middletown, CT
  • NPI 1609833730
  NPD (past)

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187308800000",
    "number": "1972522985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 WILLARD AVE",
            "address_2": "BUILDING 3",
            "city": "NEWINGTON",
            "state": "CT",
            "postal_code": "061112650",
            "telephone_number": "860-665-0174",
            "fax_number": "860-667-2066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 SAYBROOK RD",
            "address_2": "SUITE 200",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064574777",
            "telephone_number": "860-343-1240",
            "fax_number": "860-343-1250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLESEX ENDOSCOPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-08-17",
        "status": "A",
        "authorized_official_last_name": "MINEAU",
        "authorized_official_first_name": "KRIS",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "860-665-0174",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Middlesex Center for Advanced Orthopedic Surgery
• Middlesex Dental Care, LLC
• Middlesex Dermatology, LLC
• Middlesex Diabetes & Endocrinology
• Middlesex Dialysis Center LLC
• Middlesex Eye Physicians P.C.
• Middlesex Eye Physicians, P.C.
• Middlesex Gastroenterology Associates, LLC
• Middlesex Health Services, Inc.
• Middlesex Heart Institute

• Ambulatory Surgical Clinic/Center in Middletown, CT
• Providers in Middletown, CT by specialty
• Ambulatory Surgical Clinic/Center in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2007; 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.