Northeast Missouri Ambulatory Surgery Center LLC
NPI 1710982699 · Ambulatory Surgical Clinic/Center · Hannibal, MO
Enrolled with Medicare as Part B Supplier - Ambulatory Surgical Center · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Northeast Missouri Ambulatory Surgery Center LLC is a Ambulatory Surgical Clinic/Center organization in Hannibal, MO (NPI 1710982699).
Provider details
- NPI number
- 1710982699
- Entity type
- Organization
- Primary specialty
- Ambulatory Surgical Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Matthew Johnson, Administrator(573) 406-1301
- License
- 108 (MO)
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
21 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
675 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) |
|---|---|---|
| Removal of Polyps Or Growths of Large Bowel Using an Endoscope With Mechanical Snare45385 | 219 | $515 |
| Biopsy of Esophagus, Stomach, And/Or Upper Small Bowel Using a Flexible Endoscope43239 | 71 | $370 |
| Colorectal Cancer Screening; Colonoscopy on Individual at High RiskG0105 | 64 | $409 |
| Colorectal Cancer Screening; Colonoscopy on Individual Not Meeting Criteria for High RiskG0121 | 57 | $409 |
| Balloon Dilation of Esophagus, Stomach, And/Or Upper Small Bowel Using a Flexible Endoscope, Less Than 3.0 Cm43249 | 53 | $721 |
Practice location
Mailing address
Registry dates
- Enumerated
- 2005-06-16
- Last updated
- 2010-10-21
Frequently asked questions
- What is Northeast Missouri Ambulatory Surgery Center LLC's NPI number?
- Northeast Missouri Ambulatory Surgery Center LLC's National Provider Identifier (NPI) is 1710982699, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Northeast Missouri Ambulatory Surgery Center LLC?
- Northeast Missouri Ambulatory Surgery Center LLC is classified in the NPPES registry as Ambulatory Surgical Clinic/Center (Ambulatory Health Care Facilities).
- Where is Northeast Missouri Ambulatory Surgery Center LLC located?
- Northeast Missouri Ambulatory Surgery Center LLC's practice location on file with NPPES is 98 Medical Drive, Hannibal, MO 63401.
- What is Northeast Missouri Ambulatory Surgery Center LLC's phone number?
- The practice phone number listed in the NPPES registry for Northeast Missouri Ambulatory Surgery Center LLC is (573) 406-1301.
- Does Northeast Missouri Ambulatory Surgery Center LLC accept Medicare?
- Northeast Missouri Ambulatory 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 Northeast Missouri Ambulatory Surgery Center LLC?
- The authorized official listed on Northeast Missouri Ambulatory Surgery Center LLC's NPPES record is Matthew Johnson, Administrator. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Northeast Missouri Ambulatory Surgery Center LLC's NPI active?
- Yes — Northeast Missouri Ambulatory Surgery Center LLC's NPI (1710982699) is active in the NPPES registry as of the last update on 2010-10-21.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.