Puyallup Endoscopy Center – Ambulatory Surgical Clinic/Center, NPI 1790744175
Ambulatory Surgical Clinic/Center
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Puyallup Endoscopy Center
Lincoln Station Tacoma Post Office, 3705, South G Street, Lincoln International District, Eastside, Tacoma, Pierce County, Washington, 98419, United States
TACOMA, WA 984012157
Phone: (253) 841-3933
Fax: (253) 864-8412
Type: Mailing
1703, South Meridian, Puyallup, Pierce County, Washington, 98371, United States
SUITE 203
PUYALLUP, WA 983717590
Phone: (253) 841-3933
Fax: (253) 864-8412
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2016-09-14
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-03-31 (800 days ago).
Enrollment records
1
Earliest due date
2024-03-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20160914000808 | O | Ambulatory Surgical Center | WA | 2024-03-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 45380 | Biopsy of large bowel using a flexible endoscope | 269 | 269 | $0 |
| 45385 | Removal of polyps or growths of large bowel using an endoscope with mechanical snare | 179 | 179 | $0 |
| 43239 | Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope | 102 | 100 | $0 |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 80 | 79 | $0 |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 39 | 39 | $0 |
Insurance plans in this area (ZIP 98401)
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