Oregon Trail Eye Surgery Center, Inc

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

ASC039 Issued in NE

Legal business name

OREGON TRAIL EYE SURGERY CENTER, INC

Practice address

329 West 40TH Street
Scottsbluff, NE 69361-4634

Phone

(308) 635-3911

Fax

(308) 635-3130

NPI assigned

Oct 2, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Barbara J. Middle

Title

Administrator

Phone

(308) 635-3911

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

Listed as

Oregon Trail Eye Surgery CenterCCN 28C0001036

Medicare certification status

ActiveFrom the Provider of Services file

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Judson C. Martin, M.D.

  • Ophthalmology Physician
  • Scottsbluff, NE
  • NPI 1275627846
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003909789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 WEST 40TH STREET",
            "city": "SCOTTSBLUFF",
            "state": "NE",
            "postal_code": "693614634",
            "telephone_number": "308-635-3911",
            "fax_number": "308-635-3130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 WEST 40TH STREET",
            "city": "SCOTTSBLUFF",
            "state": "NE",
            "postal_code": "693614634",
            "telephone_number": "308-635-3911",
            "fax_number": "308-635-3130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OREGON TRAIL EYE SURGERY CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MIDDLE",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "308-635-3911"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NE",
            "license": "ASC039",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025073600",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5490380",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mariana D Olivera
• Angela Olmos
• Oneal Chiropractic Clinic,P.C.
• Options in Psychology LLC
• Oregon Trail Eye Center, PC
• Teresa Orellana
• Amy Oros-Garfia
• Orthotic Prosthetic Solutions, L.L.C.
• Sierra Ostdiek
• Stanley Osterhoudt

• Ambulatory Surgical Clinic/Center in Scottsbluff, NE
• Providers in Scottsbluff, NE by specialty
• Ambulatory Surgical Clinic/Center in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.