MEDICARE: ANCHORAGE ENDOSCOPY SURGICENTER, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1962384800
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANCHORAGE ENDOSCOPY SURGICENTER, LLC

Provider Business Mailing Address
First Line	:	2841 DEBARR RD STE 51
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-2968
Country	:	US
Telephone Number	:	907-222-3636
Fax Number	:

Provider Business Practice Location Address
First Line	:	2841 DEBARR RD STE 51
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-2968
Country	:	US
Telephone Number	:	907-222-3636
Fax Number	:

Authorized Official
Title or Position	:	VP/CFO
Name	:	DAVID MCKNIGHT
Credential	:
Telephone Number	:	972-789-2816

Provider Enumeration Date	:	07/22/2025
Last Update Date	:	06/09/2026

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