Evergreen Endoscopy Center, LLC
NPI 1093974602 · Ambulatory Surgical Clinic/Center · South Windsor, CT
Enrolled with Medicare as Part B Supplier - Ambulatory Surgical Center · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Evergreen Endoscopy Center, LLC is a Ambulatory Surgical Clinic/Center organization in South Windsor, CT (NPI 1093974602).
Provider details
- NPI number
- 1093974602
- Entity type
- Organization
- Primary specialty
- Ambulatory Surgical Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- William Wollman, Executive Director(860) 533-2123
Specialties & taxonomies
Ambulatory Health Care Facilities
- Endoscopy Clinic/Center261QE0800X
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
18 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)28% of score
667 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Biopsy of Large Bowel Using a Flexible Endoscope45380 | 185 | $562 |
| Biopsy of Esophagus, Stomach, And/Or Upper Small Bowel Using a Flexible Endoscope43239 | 162 | $350 |
| Removal of Polyps Or Growths of Large Bowel Using an Endoscope With Mechanical Snare45385 | 130 | $630 |
| Diagnostic Exam of Large Bowel Using a Flexible Endoscope45378 | 89 | $492 |
| Injection of Substance Into Lower Spine Canal Using Imaging Guidance62323 | 44 | $372 |
Practice location
Mailing address
Registry dates
- Enumerated
- 2008-06-09
- Last updated
- 2017-11-15
Frequently asked questions
- What is Evergreen Endoscopy Center, LLC's NPI number?
- Evergreen Endoscopy Center, LLC's National Provider Identifier (NPI) is 1093974602, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Evergreen Endoscopy Center, LLC?
- Evergreen Endoscopy Center, LLC is classified in the NPPES registry as Ambulatory Surgical Clinic/Center (Ambulatory Health Care Facilities).
- Where is Evergreen Endoscopy Center, LLC located?
- Evergreen Endoscopy Center, LLC's practice location on file with NPPES is 2400 Tamarack Avenue, South Windsor, CT 06074.
- What is Evergreen Endoscopy Center, LLC's phone number?
- The practice phone number listed in the NPPES registry for Evergreen Endoscopy Center, LLC is (860) 644-7336.
- Does Evergreen Endoscopy Center, LLC accept Medicare?
- Evergreen Endoscopy Center, LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Evergreen Endoscopy Center, LLC?
- The authorized official listed on Evergreen Endoscopy Center, LLC's NPPES record is William Wollman, Executive Director. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Evergreen Endoscopy Center, LLC's NPI active?
- Yes — Evergreen Endoscopy Center, LLC's NPI (1093974602) is active in the NPPES registry as of the last update on 2017-11-15.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.