NPIMap

Organization Active NPI

Kings Eye Center Medical Group, Inc.

Doing business as Kings Eye Surgical Center

  • Ambulatory Surgical Clinic/Center
  • Hanford, CA
National Provider Identifier
1083694319
Registry record updated Mar 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
040000455 Issued in CA
Legal business name
KINGS EYE CENTER MEDICAL GROUP, INC.
Doing business as
Kings Eye Surgical Center
Practice address
1395 W Lacey Blvd
Hanford, CA 93230-5904
Phone
(559) 585-3937
Fax
(559) 582-3645
NPI assigned
Jan 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2011

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

Authorized official

Name
Linda Lee-Thomas
Title
Administrator
Phone
(559) 585-3937

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 040000455 CA Primary

Addresses

Primary practice location

1395 W Lacey Blvd
Hanford, CA 93230-5904

Mailing address

1395 W Lacey Blvd
Hanford, CA 93230-5904
Phone (559) 585-3937

Other identifiers 1

IdentifierTypeStateIssuer
SUR01298FMedicaidCA

Other names 1

  • Kings Eye Surgical Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080516000739 CA Part B Supplier - Ambulatory Surgical Center 8527004373 Practice locations: Hanford, CA

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Kings Eye Center Medical Group IncCCN 05C0001298
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Kings Eye Center Medica2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Member of 1

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

Locations

1395 W Lacey Blvd
Hanford, CA 93230
Phone (559) 585-3937

Practitioners & affiliated clinicians

Practitioners 4

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": "1137715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300838400000",
    "number": "1083694319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 W LACEY BLVD",
            "city": "HANFORD",
            "state": "CA",
            "postal_code": "932305904",
            "telephone_number": "559-585-3937",
            "fax_number": "559-582-3645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1395 W LACEY BLVD",
            "city": "HANFORD",
            "state": "CA",
            "postal_code": "932305904",
            "telephone_number": "559-585-3937",
            "fax_number": "559-582-3645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGS EYE CENTER MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-20",
        "last_updated": "2011-03-23",
        "status": "A",
        "authorized_official_last_name": "LEE-THOMAS",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "559-585-3937"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "040000455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SUR01298F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kings Eye Surgical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hanford, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 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.