Pacific Endoscopy and Surgery Center, LLC
NPI 1104006006 · Ambulatory Surgical Clinic/Center · Fountain Valley, CA
Enrolled with Medicare as Part B Supplier - Ambulatory Surgical Center · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Pacific Endoscopy and Surgery Center, LLC is a Ambulatory Surgical Clinic/Center organization in Fountain Valley, CA (NPI 1104006006).
Provider details
- NPI number
- 1104006006
- Entity type
- Organization
- Primary specialty
- Ambulatory Surgical Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Eric Boon, Authorized Official(480) 567-0269
Specialties & taxonomies
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
1,073 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 | 301 | $520 |
| Biopsy of Esophagus, Stomach, And/Or Upper Small Bowel Using a Flexible Endoscope43239 | 283 | $441 |
| Removal of Polyps Or Growths of Large Bowel Using an Endoscope With Mechanical Snare45385 | 248 | $662 |
| Colorectal Cancer Screening; Colonoscopy on Individual Not Meeting Criteria for High RiskG0121 | 93 | $515 |
| Colorectal Cancer Screening; Colonoscopy on Individual at High RiskG0105 | 43 | $515 |
Practice location
Mailing address
Registry dates
- Enumerated
- 2007-11-07
- Last updated
- 2024-10-15
- Certified
- 2024-10-15
Frequently asked questions
- What is Pacific Endoscopy and Surgery Center, LLC's NPI number?
- Pacific Endoscopy and Surgery Center, LLC's National Provider Identifier (NPI) is 1104006006, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Pacific Endoscopy and Surgery Center, LLC?
- Pacific Endoscopy and Surgery Center, LLC is classified in the NPPES registry as Ambulatory Surgical Clinic/Center (Ambulatory Health Care Facilities).
- Where is Pacific Endoscopy and Surgery Center, LLC located?
- Pacific Endoscopy and Surgery Center, LLC's practice location on file with NPPES is 17815 Newhope St, Fountain Valley, CA 92708-5426.
- What is Pacific Endoscopy and Surgery Center, LLC's phone number?
- The practice phone number listed in the NPPES registry for Pacific Endoscopy and Surgery Center, LLC is (714) 432-8881.
- Does Pacific Endoscopy and Surgery Center, LLC accept Medicare?
- Pacific Endoscopy and Surgery 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 Pacific Endoscopy and Surgery Center, LLC?
- The authorized official listed on Pacific Endoscopy and Surgery Center, LLC's NPPES record is Eric Boon, Authorized Official. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Pacific Endoscopy and Surgery Center, LLC's NPI active?
- Yes — Pacific Endoscopy and Surgery Center, LLC's NPI (1104006006) is active in the NPPES registry as of the last update on 2024-10-15.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.