NORTHEAST MISSOURI AMBULATORY SURGERY CENTER LLC
NPI 1710982699
Clinic/Center - Ambulatory Surgical in Hannibal, MO
NPI Status: Active since June 16, 2005
Contact Information
98 MEDICAL DRIVE
HANNIBAL, MO
ZIP 63401
Phone: (573) 406-1301
Fax: (573) 406-0511
- Organization
- Clinic/Center
- Ambulatory Surgical
- Accepts Insurance
- CLIA Number: 26D0975386
- CLIA Cert. Type: Ambulatory Surgery Center
- CLIA Exp. Date: 07-05-2026
About NORTHEAST MISSOURI AMBULATORY SURGERY CENTER LLC
This page provides the complete NPI Profile along with additional information for Northeast Missouri Ambulatory Surgery Center Llc, a provider established in Hannibal, Missouri operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1710982699 assigned on June 2005. The practitioner's primary taxonomy code is 261QA1903X with license number 108 (MO). The provider is registered as an organization and their NPI record was last updated 15 years ago. The authorized official of this NPI record is Matthew Johnson (Administrator)
- NPI
- 1710982699
- Provider Name
- NORTHEAST MISSOURI AMBULATORY SURGERY CENTER LLC
- Entity Type
- Organization
- Location Address
- 98 MEDICAL DRIVE HANNIBAL, MO 63401
- Location Phone
- (573) 406-1301
- Location Fax
- (573) 406-0511
- Mailing Address
- PO BOX 511 HANNIBAL, MO 63401
- Mailing Phone
- (573) 406-1301
- Mailing Fax
- (573) 406-0511
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 06-16-2005
- Last Update Date
- 10-21-2010
- Code Navigator
Location Map
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.
- 108
- License State
- MO
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Pathway 6900 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Bronze Pathway 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Bronze Pathway 9200 (+ Incentives) - EPO
- Anthem Catastrophic Pathway 9200 (+ Incentives) - EPO
- Anthem Gold Pathway 1500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Heart Healthy Bronze Pathway 4900 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Heart Healthy Silver Pathway 2900 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Silver Pathway 5000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Silver Pathway 5350 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Silver Pathway 7250 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Bronze Standard (No Referrals) - EPO
- UHC Bronze Value ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - EPO
- UHC Bronze Value+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
- UHC Gold Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - EPO
- UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - EPO
- UHC Gold Standard (No Referrals) - EPO
- UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - EPO
- UHC Silver Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
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.
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.
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 |
|---|---|---|---|
| 143365 | OTHER (01) | MO | BCBS PROVIDER ID |
| =========001 | MEDICAID (05) | IL | |
| 505073205 | MEDICAID (05) | MO | |
| 431607 | OTHER (01) | MO | HEALTHLINK PROVIDER ID |
| 490004674 | OTHER (01) | MO | RAILROAD MEDICARE |
| 000040048 | MEDICARE ID-TYPE UNSPECIFIED (04) | MO | MEDICARE PROVIDER NUMBER |
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.
Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, less than 3.0 cm
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope
Biopsy of large bowel using a flexible endoscope
Biopsy of prostate gland
Colorectal cancer screening; colonoscopy on individual at high risk
Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk
Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope
Diagnostic exam of large bowel using a flexible endoscope
Incision of tendon covering of finger
Injection of substance into lower spine canal using imaging guidance
Release of wrist ligament using an endoscope
Removal of extensive shoulder joint tissue using an endoscope
Removal of knee cartilage using an endoscope
Removal of polyps or growths of large bowel using an endoscope with mechanical snare
Repair of shoulder rotator cuff using an endoscope
This procedure involves using a flexible tube with a camera, called an endoscope, to gently expand narrowed areas in your esophagus, stomach, or upper small bowel. A small balloon is inflated, making it easier for food and liquid to pass through. It's safe and effective.
This service was performed 47 times for 45 patientsThis 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 91 times for 91 patientsA 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 74 times for 74 patientsA biopsy of the prostate gland is a procedure where a small sample of tissue is taken from your body's internal gland, located near the bladder, for testing. This helps in diagnosing potential health issues. It's usually done with a fine needle and imaging technology for accuracy.
This service was performed 12 times for 12 patientsColorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.
This service was performed 49 times for 49 patientsColorectal cancer screening, such as a colonoscopy, is a preventive measure to detect early signs of cancer in the large intestine. For individuals not at high risk, it's typically recommended at age 50. A small, flexible tube with a camera is used to examine your colon. It's a safe, effective way to catch issues early.
This service was performed 65 times for 65 patientsThis procedure, known as an upper endoscopy, involves inserting a thin, flexible tube with a camera down the throat to examine the esophagus, stomach, and upper small bowel. It helps diagnose conditions like ulcers or inflammation.
This service was performed 24 times for 24 patientsThis procedure, known as a colonoscopy, involves using a flexible tube with a light and camera to examine the large intestine. It helps detect any abnormalities such as polyps or inflammation. It's a standard procedure to ensure gut health.
This service was performed 37 times for 37 patientsThis procedure involves making a small cut into the protective sheath around a finger tendon. It's typically done to relieve pressure or inflammation, improve finger movement, or treat conditions like trigger finger. It's a safe, often outpatient procedure.
This service was performed 20 times for 19 patientsThis procedure involves injecting a substance into your lower spine canal, guided by real-time images. It's done to diagnose or treat various conditions. You may feel slight discomfort, but it's generally safe and can provide valuable information for your treatment plan.
This service was performed 51 times for 42 patientsThis procedure involves using a small camera, called an endoscope, to view and treat a tight wrist ligament. The endoscope is inserted through a tiny incision, reducing recovery time and scarring. It helps to relieve pain and improve wrist function.
This service was performed 38 times for 35 patientsThis procedure, known as arthroscopic debridement, involves using a small camera (endoscope) to view your shoulder joint. Damaged or unwanted tissue is then carefully removed. This minimally invasive technique aims to reduce pain and improve joint mobility.
This service was performed 12 times for 12 patientsThis procedure, known as arthroscopic knee surgery, involves using a small camera (endoscope) to view the inside of your knee. Small instruments are used to remove damaged cartilage. This can help alleviate pain and improve knee function.
This service was performed 13 times for 13 patientsThis 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 231 times for 231 patientsThis procedure, known as arthroscopic rotator cuff repair, helps fix tears in the shoulder's rotator cuff. An endoscope, a small camera, is used to view the shoulder inside. Using small tools, the surgeon repairs the torn tissue. This minimally invasive approach often leads to a quicker recovery.
This service was performed 19 times for 19 patientsCLIA 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
- 26D0975386
- Facility Type
- Ambulatory Surgery Center
- Certificate Effective Date
- July 06, 2024
- Certificate Expiration Date
- July 05, 2026
- Laboratory Director
- GREGORY TERAIKIAN
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Northeast Missouri Ambulatory Surgery Center Llc 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 Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 7 | 1 | 0 | 9 | 8 | 2 | 6 | 9 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 2 | 0 | 18 | 8 | 4 | 6 | 18 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 2 + 0 + 1 + 8 + 8 + 4 + 6 + 1 + 8 + 24 = 71 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 80 - 71 = 9 | 9 | ||||||||
The NPI number 1710982699 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 4 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1710985312 | THOMAS TURNER CRNA Individual | Anesthesiology | 98 MEDICAL DRIVE HANNIBAL, MO 63401 (573) 406-1301 |
| 1063410769 | TRIA WILHITE M.D. Individual | Anesthesiology | 98 MEDICAL DRIVE HANNIBAL, MO 63401 (573) 406-1301 |
| 1306844972 | LAWERENCE LAUER CRNA Individual | Anesthesiology | 98 MEDICAL DRIVE HANNIBAL, MO 63401 (573) 406-1301 |
| 1023016714 | HANNIBAL ANESTHESIA ASSOCIATES LLC Organization | Anesthesiology | 98 MEDICAL DRIVE HANNIBAL, MO 63401 (573) 406-1301 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1710982699, enumerated in the NPI registry as an "organization" on June 16, 2005
The provider is located at 98 Medical Drive Hannibal, Mo 63401 and the phone number is (573) 406-1301
This medical organization specializes in Clinic/Center with taxonomy code 261QA1903X with a focus in Ambulatory Surgical
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield,. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The most common procedures or services performed by this practitioner are: Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, less than 3.0 cm, Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope, Biopsy of large bowel using a flexible endoscope, Biopsy of prostate gland, Colorectal cancer screening; colonoscopy on individual at high risk, Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk, Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope, Diagnostic exam of large bowel using a flexible endoscope, Incision of tendon covering of finger, Injection of substance into lower spine canal using imaging guidance, Release of wrist ligament using an endoscope, Removal of extensive shoulder joint tissue using an endoscope, Removal of knee cartilage using an endoscope, Removal of polyps or growths of large bowel using an endoscope with mechanical snare and Repair of shoulder rotator cuff using an endoscope.
The provider's CLIA number is 26D0975386 for a "ambulatory surgery center" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued 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..
This NPI record was last updated on June 16, 2005. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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