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MANSFIELD ENDOSCOPY CENTER, LLC
NPI 1366047433
Clinic/Center - Ambulatory Surgical in Mansfield, TX

Active since December 04, 2020CLIA 45D2209350 · Waiver
647 N MILLER RD, MANSFIELD, TX 76063(817) 893-2381 Get Directions Write a Review

NPPES record last updated: June 29, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 12, 2021, Jan 13, 2021, Dec 4, 2020 (3 updates tracked since 2020).

About Mansfield Endoscopy Center, Llc NPPES

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

MANSFIELD ENDOSCOPY CENTER, LLC (NPI 1366047433) is a healthcare organization registered as an ambulatory surgical in Mansfield, Texas and active in the NPI registry since December 2020. The organization holds a CLIA Waiver certificate valid through January 12, 2027 and lists Kelly Rouvaldt, Director Of Asc Operations, as its authorized official.

NPPES Registry Identity

NPI1366047433
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameMANSFIELD ENDOSCOPY CENTER, LLC
Location Address647 N MILLER RDMansfield, TX 76063-5820
Mailing Address647 N Miller RdMansfield, TX 76063-6083 · (817) 415-9670
Phone(817) 893-2381
Organization SubpartYesParent: Gi Alliance Surgery Center, Pllc
Authorized OfficialKelly RouvaldtDirector Of Asc Operations · (817) 415-9670
Enumeration DateDecember 4, 2020
Last NPPES UpdateJune 29, 20223 updates tracked since enumeration
NPPES CertifiedFebruary 24, 2022
✔ NPI 1366047433 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
647 N MILLER RD, Mansfield, TX 76063
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

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 45D2209350

Mansfield Endoscopy Center · Mansfield, TX
Active · expires Jan 12, 2027
CLIA Number45D2209350
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateJanuary 13, 2025
Certificate Expiration DateJanuary 12, 2027
Laboratory DirectorSuwebatu Odunsi-Shiyanbade
Laboratory Phone(817) 415-9670
Laboratory LocationMansfield Endoscopy Center647 N Miller Rd, Mansfield, TX 76063
CLIA data matches this NPI record on: Address Name Phone
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.
112 services112 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.
104 services104 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.
94 services94 patients
Insertion of guide wire with dilation of esophagus using a flexible endoscope 43248
This is a procedure where a thin tube, called an endoscope, is gently passed through your mouth into your esophagus. A guide wire is then inserted to help widen any narrow areas. This helps improve swallowing and reduce discomfort.
23 services23 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.
23 services23 patients
Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43235
This procedure, known as an upper endoscopy, involves inserting a thin, flexible tube with a camera down the throat to examine the esophagus, stomach, and upper small bowel. It helps diagnose conditions like ulcers or inflammation.
20 services20 patients

Other Providers at the Same Location NPPES

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

LITTEE ANNA SAM FNP
Nurse Practitioner (Family)
647 N MILLER RD
MANSFIELD, TX 76063
Tarrant County (423) 596-7955

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 Mansfield Endoscopy Center, LLC's NPI number?

The NPI number for Mansfield Endoscopy Center, LLC is 1366047433. It was assigned to this organization in the NPPES registry on December 4, 2020.

Where is Mansfield Endoscopy Center, LLC located?

Mansfield Endoscopy Center, LLC is located at 647 N Miller Rd, Mansfield, TX 76063. The listed phone number is (817) 893-2381.

What is Mansfield Endoscopy Center, LLC's specialty?

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

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

Yes. A Certificate of Waiver (number 45D2209350) is associated with this NPI, valid through January 12, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Mansfield Endoscopy Center, LLC accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 2 other insurers list Mansfield Endoscopy Center, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mansfield Endoscopy Center, LLC was last updated on June 29, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.