Vision Surgery & Laser Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

071532 Issued in OR

Legal business name

VISION SURGERY & LASER CENTER, LLC

Practice address

2435 NW Kline St
Roseburg, OR 97471-1687

Phone

(541) 672-2020

Fax

(541) 673-8084

NPI assigned

Jun 12, 2006

Last updated

Jun 26, 2015By 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

Dr. Jon-Marc Weston, M.D.NPI 1629072053

Title

Owner

Phone

(541) 672-2020

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Listed as

Vision Surgery and Laser Center LLCCCN 38C0001041

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Ba Ventures LLC

  • Anesthesiology Physician
  • Roseburg, OR
  • NPI 1154093847

  Member Of

  NPD member

Locations

Practitioners 2

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.

• Jon-Marc Weston, MD

  • Ophthalmology Physician
  • Roseburg, OR
  • NPI 1629072053
  Authorized official Same address or phone
• Balamurali Krishna Ambati, MD

  • Ophthalmology Physician
  • Eugene, OR
  • NPI 1750397576
  NPD (past)

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435276800000",
    "number": "1053353359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2435 NW KLINE ST",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974701690",
            "telephone_number": "541-672-2020",
            "fax_number": "541-673-8084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2435 NW KLINE ST",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974711687",
            "telephone_number": "541-672-2020",
            "fax_number": "541-673-8084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISION SURGERY & LASER CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2015-06-26",
        "status": "A",
        "authorized_official_last_name": "WESTON",
        "authorized_official_first_name": "JON-MARC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-672-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "OR",
            "license": "071532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "262457",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen Vian, RN
• Humberto Jesus Villalvazo, MD
• Christine Yap Villardo, M.D.
• Sergio J Villegas, DO
• Venus Vincent
• Denise Viss
• Emmalee Vittetoe
• Hien Emily Vo
• Lanette Vo, PHARMD
• Aryn Voigt

• Ambulatory Surgical Clinic/Center in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Ambulatory Surgical Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2015; 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.