ST AUGUSTINE ENDOSCOPY CENTER LLC NPI 1841251501

NPI Information

  • NPI: 1841251501
  • Provider Name: ST AUGUSTINE ENDOSCOPY CENTER LLC
  • Classification: Clinic/Center - 261QA1903X
  • Specialization: Ambulatory Surgical
  • Entity Type: Organization
  • CLIA Number: 10D1074662
  • Address: 212 SOUTHPARK CIR E
    ST AUGUSTINE, FL
    ZIP 32086
  • Phone: (904) 824-6108

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NPI Details

ST AUGUSTINE ENDOSCOPY CENTER LLC is an ambulatory surgical clinic center in St Augustine, FL. ST AUGUSTINE ENDOSCOPY CENTER LLC NPI is 1841251501. The provider is registered as an organization entity type.

The provider's business location address is:

212 SOUTHPARK CIR E
ST AUGUSTINE, FL
ZIP 32086-135
Phone: (904) 824-6108
Fax: (904) 823-9613

The provider's authorized official is Collin Lemaistre .
The authorized official title is Officer/authorized Official and has the following contact phone number (469) 250-3640.

The CLIA number assigned to this NPI record is 10D1074662 - 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 esophagus, stomach, and/or upper small bowel using a flexible endoscope (HCPCS:43239)
  • Biopsy of large bowel using a flexible endoscope (HCPCS:45380)
  • Removal of polyps or growths of large bowel using an endoscope with mechanical snare (HCPCS:45385)
  • 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)
  • Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk (HCPCS:G0121)
  • Diagnostic exam of large bowel using a flexible endoscope (HCPCS:45378)
  • Dilation of esophagus (HCPCS:43450)
  • Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope (HCPCS:43235)
  • Biopsy of lower large bowel using a flexible endoscope (HCPCS:45331)
  • Removal of large bowel tissue using a flexible endoscope (HCPCS:45390)
  • Banding of hemorrhoids using a flexible endoscope (colonoscope) (HCPCS:45398)
  • Injection beneath lining of large bowel using a flexible endoscope (HCPCS:45381)
  • Removal of polyps or growths of esophagus, stomach, and/or upper small bowel using an endoscope with mechanical snare (HCPCS:43251)
  • Control of bleeding of esophagus, stomach, and/or upper small bowel using a flexible endoscope (HCPCS:43255)
  • Diagnostic exam of lower portion of large bowel using a flexible endoscope (HCPCS:45330)
  • Control of bleeding of upper large bowel using a flexible endoscope (HCPCS:45382)

The enumeration date for this NPI number is 3/31/2006 and was last updated on 10/29/2024.

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 Surgical812FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1079055900MEDICAIDFLORIDA

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: 11/21/2025

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