NPIMap

Organization Active NPI

Lakewood Eye Physicians and Surgeons Inc a Medical Group

  • Ambulatory Surgical Clinic/Center
  • Long Beach, CA
National Provider Identifier
1043473390
Registry record updated Mar 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
LAKEWOOD EYE PHYSICIANS AND SURGEONS INC A MEDICAL GROUP
Practice address
3300 E South St
Suite 107
Long Beach, CA 90805-4550
Phone
(562) 531-2020
Fax
(562) 531-1142
NPI assigned
Jul 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2009

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

Authorized official

Name
Mrs. Caroline Barragan
Title
Credentialing
Phone
(562) 531-2020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X CA Primary

Addresses

Primary practice location

3300 E South St
Suite 107
Long Beach, CA 90805-4550

Mailing address

3300 E South St
Suite 105
Long Beach, CA 90805-4550
Phone (562) 531-2020

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ79385ZMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060224000702 CA Part B Supplier - Ambulatory Surgical Center 4789647983 Receives reassigned benefits from 5 practitioners
Practice locations: Lakewood, CA

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Lakewood Eye Physicians and SurgeonsCCN 55C0001044
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Lakewood Eye Physicians and3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1215475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236038400000",
    "number": "1043473390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 E SOUTH ST",
            "address_2": "SUITE 105",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908054550",
            "telephone_number": "562-531-2020",
            "fax_number": "562-531-1142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 E SOUTH ST",
            "address_2": "SUITE 107",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908054550",
            "telephone_number": "562-531-2020",
            "fax_number": "562-531-1142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEWOOD EYE PHYSICIANS AND SURGEONS INC A MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-08",
        "last_updated": "2009-03-03",
        "status": "A",
        "authorized_official_last_name": "BARRAGAN",
        "authorized_official_first_name": "CAROLINE",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "562-531-2020",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ79385Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2009; 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.