EVERGREEN ENDOSCOPY CENTER, LLC
NPI 1093974602
Clinic/Center - Ambulatory Surgical in South Windsor, CT

Q: What is Evergreen Endoscopy Center, LLC's NPI number?

The NPI number for Evergreen Endoscopy Center, LLC is 1093974602. It was assigned to this organization in the NPPES registry on June 9, 2008.

Q: What is Evergreen Endoscopy Center, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Active since June 09, 2008CLIA 07D1085306 · Waiver

2400 TAMARACK AVENUE, SUITE 100, SOUTH WINDSOR, CT 06074(860) 644-7336 Get Directions Write a Review

NPPES record last updated: November 15, 2017. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Evergreen Endoscopy Center, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EVERGREEN ENDOSCOPY CENTER, LLC (NPI 1093974602) is a healthcare organization registered as an ambulatory surgical in South Windsor, Connecticut and active in the NPI registry since June 2008. The organization holds a CLIA Waiver certificate valid through June 12, 2028 and lists William A Wollman, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1093974602

Entity TypeOrganization

Primary Taxonomy261QA1903X

Legal Business NameEVERGREEN ENDOSCOPY CENTER, LLC

Location Address2400 TAMARACK AVENUE, SUITE 100South Windsor, CT 06074

Mailing Address2400 Tamarack Avenue, Suite 100South Windsor, CT 06074 · (860) 644-7336

Phone(860) 644-7336

Organization SubpartNo

Authorized OfficialWilliam A WollmanExecutive Director · (860) 533-2123

Enumeration DateJune 9, 2008

Last NPPES UpdateNovember 15, 2017

✔ NPI 1093974602 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities

Taxonomy Code261QA1903X

Also ListedClinic/Center · EndoscopyTaxonomy 261QE0800X

2400 TAMARACK AVENUE, South Windsor, CT 06074

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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 07D1085306

Evergreen Endoscopy Center LLC · South Windsor, CT

Active · expires Jun 12, 2028

CLIA Number07D1085306

Laboratory TypeOther

Certificate Effective DateJune 13, 2026

Certificate Expiration DateJune 12, 2028

Laboratory DirectorJoseph H. Ianello

Laboratory Phone(860) 646-6383

Laboratory LocationEvergreen Endoscopy Center LLC2400 Tamarack Ave Ste 100, South Windsor, CT 06074

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

185 services183 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

162 services153 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

130 services128 patients

Diagnostic exam of large bowel using a flexible endoscope 45378

This procedure, known as a colonoscopy, involves using a flexible tube with a light and camera to examine the large intestine. It helps detect any abnormalities such as polyps or inflammation. It's a standard procedure to ensure gut health.

89 services87 patients

Injection of substance into lower spine canal using imaging guidance 62323

This procedure involves injecting a substance into your lower spine canal, guided by real-time images. It's done to diagnose or treat various conditions. You may feel slight discomfort, but it's generally safe and can provide valuable information for your treatment plan.

44 services35 patients

Colorectal cancer screening; colonoscopy on individual at high risk G0105

Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.

34 services34 patients

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ACCLAIM BEHAVIORAL SERVICES, LLC

Psychologist

2400 TAMARACK AVENUE
SOUTH WINDSOR, CT 06074

Capitol Planning Region (860) 539-6779

JANIS INESIS BRIGA PH.D.

Psychologist

2400 TAMARACK AVENUE, SUITE 201
SOUTH WINDSOR, CT 06074

Capitol Planning Region (860) 432-1199

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Evergreen Endoscopy Center, LLC's NPI number?

The NPI number for Evergreen Endoscopy Center, LLC is 1093974602. It was assigned to this organization in the NPPES registry on June 9, 2008.

Where is Evergreen Endoscopy Center, LLC located?

Evergreen Endoscopy Center, LLC is located at 2400 Tamarack Avenue Suite 100, South Windsor, CT 06074. The listed phone number is (860) 644-7336.

What is Evergreen Endoscopy Center, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Does Evergreen Endoscopy Center, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 07D1085306) is associated with this NPI, valid through June 12, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Evergreen Endoscopy Center, LLC was last updated on November 15, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.