Desoto Eye Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

DESOTO EYE SURGERY CENTER LLC

Practice address

726 Goodman Rd E
Suite B
Southaven, MS 38671-9530

Phone

(662) 349-1959

Fax

(662) 349-0424

NPI assigned

Mar 11, 2009

Last updated

Apr 5, 2012By 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. Alan R. Schaeffer, M.D.NPI 1912937574

Title

Managing Member

Phone

(662) 349-1959

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1073754602. Details of each certification follow.

• CCN 25C0001078 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 25C0001078

Legal name

DESOTO EYE SURGERY CENTER, LLC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Nov 1, 2010

Last certification

Dec 17, 2019

Ownership / control type

Proprietary

Facility address

726 Goodman Road E Suite B
Southaven, MS 38671

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

CLIA laboratory certificates

Locations

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.

• Alan R Schaeffer, MD

  • Ophthalmology Physician
  • Southaven, MS
  • NPI 1912937574
  NPD (past) Authorized official

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

{
    "created_epoch": "1236729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333584000000",
    "number": "1073754602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "726 GOODMAN RD E",
            "address_2": "SUITE B",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386719530",
            "telephone_number": "662-349-1959",
            "fax_number": "662-349-0424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "726 GOODMAN RD E",
            "address_2": "SUITE B",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386719530",
            "telephone_number": "662-349-1959",
            "fax_number": "662-349-0424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESOTO EYE SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-11",
        "last_updated": "2012-04-05",
        "status": "A",
        "authorized_official_last_name": "SCHAEFFER",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "662-349-1959",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Desoto Adult Medicine Associates, PLLC
• Desoto County Chiropractic, Inc.
• Desoto County School
• Desoto Dna and Diagnostic Center
• Desoto Eye and Ear
• Desoto Eyecare Inc
• Desoto Family Care Clinic, PLLC
• Desoto Family Counseling Center PLLC
• Desoto Family Counseling Center, PLLC
• Desoto Family Medical Center

• Ambulatory Surgical Clinic/Center in Southaven, MS
• Providers in Southaven, MS by specialty
• Ambulatory Surgical Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.