NPIMap

Organization Active NPI

New Vision Surgical Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Vero Beach, FL
National Provider Identifier
1063701977
Registry record updated Oct 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
1345 Issued in FL
Legal business name
NEW VISION SURGICAL CENTER, LLC
Practice address
1055 37TH PL
Vero Beach, FL 32960-6551
Phone
(772) 257-8700
Fax
(772) 257-8715
NPI assigned
Mar 31, 2011
Last updated
Oct 3, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2011

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

Authorized official

Name
Dr. Paul Victor Minotty, MDNPI 1124073598
Title
Manager
Phone
(772) 257-8700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 1345 FL Primary

Addresses

Primary practice location

1055 37TH PL
Vero Beach, FL 32960-6551

Mailing address

1055 37TH PL
Vero Beach, FL 32960-6551
Phone (772) 257-8700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110509000345 FL Part B Supplier - Ambulatory Surgical Center 2961688965 Practice locations: Vero Beach, FL

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
New Vision Surgical Center LLCCCN 10C0001563
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2023031New Vision Surgical Center LLC1055 37TH PL, Vero Beach, FL 32960Certificate of waiverApr 13, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1301529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317600000000",
    "number": "1063701977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 37TH PL",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329606551",
            "telephone_number": "772-257-8700",
            "fax_number": "772-257-8715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 37TH PL",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329606551",
            "telephone_number": "772-257-8700",
            "fax_number": "772-257-8715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW VISION SURGICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-31",
        "last_updated": "2011-10-03",
        "status": "A",
        "authorized_official_last_name": "MINOTTY",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "VICTOR",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "772-257-8700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "FL",
            "license": "1345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2011; 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.