SHADELANDS ADVANCED ENDOSCOPY INSTITUTE INC. NPI 1184798837

NPI Information

  • NPI: 1184798837
  • Provider Name: SHADELANDS ADVANCED ENDOSCOPY INSTITUTE, INC.
  • Classification: Clinic/Center - 261QA1903X
  • Specialization: Ambulatory Surgical
  • Entity Type: Organization
  • CLIA Number: 05D1066451
  • Address: 498 N WIGET LN
    WALNUT CREEK, CA
    ZIP 94598
  • Phone: (925) 933-3600

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NPI Details

SHADELANDS ADVANCED ENDOSCOPY INSTITUTE, INC. is an ambulatory surgical clinic center in Walnut Creek, CA. SHADELANDS ADVANCED ENDOSCOPY INSTITUTE, INC. NPI is 1184798837. The provider is registered as an organization entity type.

The provider's business location address is:

498 N WIGET LN
WALNUT CREEK, CA
ZIP 94598-408
Phone: (925) 933-3600
Fax: (925) 933-7900

The provider's authorized official is Inez Wondeh .
The authorized official title is Coo and has the following contact phone number (925) 378-4500.

The CLIA number assigned to this NPI record is 05D1066451 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Biopsy of large bowel using a flexible endoscope (HCPCS:45380)
  • Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope (HCPCS:43239)
  • Removal of polyps or growths of large bowel using an endoscope with mechanical snare (HCPCS:45385)
  • Diagnostic exam of large bowel using a flexible endoscope (HCPCS:45378)
  • Colorectal cancer screening; colonoscopy on individual at high risk (HCPCS:G0105)
  • Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, less than 3.0 cm (HCPCS:43249)
  • Injection beneath lining of large bowel using a flexible endoscope (HCPCS:45381)
  • Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk (HCPCS:G0121)
  • Removal of polyps or growths of esophagus, stomach, and/or upper small bowel using an endoscope with mechanical snare (HCPCS:43251)

The enumeration date for this NPI number is 11/17/2006 and was last updated on 1/2/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QA1903XClinic/CenterAmbulatory SurgicalYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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