ENDOSCOPY CENTER OF SAN JOSE
NPI 1598815110
Clinic/Center - Ambulatory Surgical in San Jose, CA

NPI Status: Active since January 12, 2007

Contact Information

2100 FOREST AVE
SUITE 109
SAN JOSE, CA
ZIP 95128
Phone: (408) 297-2314
Fax: (408) 297-2414

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  • Organization
  • Clinic/Center
  • Ambulatory Surgical
  • CLIA Number: 05D1039487
  • CLIA Cert. Type: Ambulatory Surgery Center
  • CLIA Exp. Date: 04-13-2027

About ENDOSCOPY CENTER OF SAN JOSE

This page provides the complete NPI Profile along with additional information for Endoscopy Center Of San Jose, a provider established in San Jose, California operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1598815110 assigned on January 2007. The practitioner's primary taxonomy code is 261QA1903X with license number 070000639 (CA). The provider is registered as an organization and their NPI record was last updated 18 years ago. The provider's other name is Endoscopy Center Of San Jose. The authorized official of this NPI record is Dr. Felix K. Tam M.d. (Clinic Director/secretary Of Atf Co)

NPI
1598815110
Provider Legal Name
EXECUTIVE ENDOSCOPY, INC.
Other Organization Name
ENDOSCOPY CENTER OF SAN JOSE
Other Name Type
Other Name (5)
Entity Type
Organization
Location Address
2100 FOREST AVE SUITE 109 SAN JOSE, CA 95128
Location Phone
(408) 297-2314
Location Fax
(408) 297-2414
Mailing Address
2100 FOREST AVE SUITE 109 SAN JOSE, CA 95128
Mailing Phone
(408) 297-2314
Mailing Fax
(408) 297-2414
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
01-12-2007
Last Update Date
08-15-2008
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Ambulatory Surgical

Taxonomy Code
261QA1903X
Type
Ambulatory Health Care Facilities
License No.
070000639
License State
CA

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1261QE0800XAmbulatory Health Care Facilities

Clinic/Center
Endoscopy

(CA)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. FELIX K. TAM M.D.

Authorized Official Title
CLINIC DIRECTOR/SECRETARY OF ATF CO
Authorized Official Phone
(408) 297-2314

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
SUR01553FMEDICAID (05)CA 
ZZZ23461ZMEDICARE PIN (08)CA 

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

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

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.

This service was performed 47 times for 46 patients

Biopsy of large bowel using a flexible endoscope

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.

This service was performed 65 times for 63 patients

Removal of large bowel tissue using a flexible endoscope

This procedure, known as a colonoscopy, involves using a flexible endoscope to examine and potentially remove tissue from the large intestine. The endoscope allows the doctor to view the bowel lining directly and remove any abnormal tissue for further analysis.

This service was performed 24 times for 22 patients

Removal of polyps or growths of esophagus, stomach, and/or upper small bowel using an endoscope with mechanical snare

This procedure involves the use of a thin, flexible instrument called an endoscope to visualize and remove abnormal growths, known as polyps, from the esophagus, stomach, or upper small bowel. A tool called a mechanical snare is used to safely cut and remove these growths.

This service was performed 59 times for 53 patients

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

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.

This service was performed 70 times for 70 patients

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
05D1039487
Facility Type
Ambulatory Surgery Center
Certificate Effective Date
April 14, 2025
Certificate Expiration Date
April 13, 2027
Laboratory Director
DAVID CHUI
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Endoscopy Center Of San Jose to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1598815110, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 60. The final step is to find the difference between that total and the next multiple of ten (60 - 60 = 0).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
5
Unchanged
Pos 3
9
Doubled → 18 → 1 + 8
Pos 4
8
Unchanged
Pos 5
8
Doubled → 16 → 1 + 6
Pos 6
1
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
1
Unchanged
Pos 9
1
Doubled → 2
Check
0
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 9 → 18 → 9 8 → 16 → 7 5 → 10 → 1 1 → 2

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 5 + 1 + 8 + 8 + 1 + 6 + 1 + 1 + 0 + 1 + 2 + 24 = 60

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 60 is 60. The difference is the calculated check digit.

60 - 60 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1598815110.

Other Providers at the Same Location


The following 17 providers are registered at the same or a nearby location.

Internal Medicine
2100 FOREST AVE, SUITE 108
SAN JOSE, CA 95128
Anesthesiology
2100 FOREST AVE
SAN JOSE, CA 95128
Obstetrics & Gynecology
2100 FOREST AVE, STE 105
SAN JOSE, CA 95128
Ophthalmology
2100 FOREST AVE, SUITE 105
SAN JOSE, CA 95128
Internal Medicine (Interventional Cardiology)
2100 FOREST AVE, SUITE 101
SAN JOSE, CA 95128
Internal Medicine
2100 FOREST AVE, SUITE 104
SAN JOSE, CA 95128
Dermatology
2100 FOREST AVE, #103
SAN JOSE, CA 95128
Internal Medicine (Infectious Disease)
2100 FOREST AVE, #106
SAN JOSE, CA 95128
Internal Medicine (Gastroenterology)
2100 FOREST AVE, 102
SAN JOSE, CA 95128
Ophthalmology
2100 FOREST AVE, SUITE 110
SAN JOSE, CA 95128
Clinic/Center (Ambulatory Surgical)
2100 FOREST AVE, 109
SAN JOSE, CA 95128
Internal Medicine
2100 FOREST AVE, SUITE 104
SAN JOSE, CA 95128
Optometrist
2100 FOREST AVE, STE 110
SAN JOSE, CA 95128
Internal Medicine
2100 FOREST AVE, SUITE 104
SAN JOSE, CA 95128
Clinic/Center (Federally Qualified Health Center (FQHC))
2100 FOREST AVE
SAN JOSE, CA 95128
Clinic/Center
2100 FOREST AVE
SAN JOSE, CA 95128
Internal Medicine
2100 FOREST AVE, SUITE 104
SAN JOSE, CA 95128

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1598815110, enumerated as an "organization" on January 12, 2007.

The provider is located at 2100 FOREST AVE SUITE 109 SAN JOSE, CA 95128 and the phone number is (408) 297-2314.

Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.