NPIMap

Organization Active NPI

Midwest Eye Consultants, P.C.

Doing business as CLI Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Fort Wayne, IN
National Provider Identifier
1093778052
Registry record updated Jul 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
MIDWEST EYE CONSULTANTS, P.C.
Doing business as
CLI Surgery Center
Practice address
7747 W Jefferson Blvd
Suite B
Fort Wayne, IN 46804-4135
Phone
(260) 434-9104
Fax
(260) 434-9105
NPI assigned
Apr 10, 2006
Last updated
Jul 9, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
MIDWEST EYE CONSULTANTS, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 9, 2010

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

Authorized official

Name
Gregory L Garner, O.D.NPI 1639139801
Title
Pres./Ceo
Phone
(260) 569-9550

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

7747 W Jefferson Blvd
Suite B
Fort Wayne, IN 46804-4135

Mailing address

7747 W Jefferson Blvd
Suite B
Fort Wayne, IN 46804-4135
Phone (260) 434-9104

Other identifiers 1

IdentifierTypeStateIssuer
200421610AMedicaidIN

Other names 1

  • CLI Surgery Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050121000296 IN Part B Supplier - Ambulatory Surgical Center 2961399217 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
Practice locations: Fort Wayne, IN; Kokomo, IN

Other NPIs with the same Medicare PAC ID 11

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

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Cli Surgery CenterCCN 15C0001123
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
15D1007693Cli Surgery Center7747 W Jefferson Ste B, Fort Wayne, IN 46804Certificate of waiverDec 26, 2026

National Provider Directory

National Provider Directory
Tax ID family
Midwest Eye Consultants PC28 organizations share this tax ID, including this one
Part of
Midwest Eye Consultants PC

Other organizations with this tax ID 27

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

View all 27

Locations

7747 W Jefferson Blvd
#B
Fort Wayne, IN 46804
Phone (260) 434-9104

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278633600000",
    "number": "1093778052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7747 W JEFFERSON BLVD",
            "address_2": "SUITE B",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044135",
            "telephone_number": "260-434-9104",
            "fax_number": "260-434-9105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7747 W JEFFERSON BLVD",
            "address_2": "SUITE B",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044135",
            "telephone_number": "260-434-9104",
            "fax_number": "260-434-9105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST EYE CONSULTANTS, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MIDWEST EYE CONSULTANTS, P.C.",
        "enumeration_date": "2006-04-10",
        "last_updated": "2010-07-09",
        "status": "A",
        "authorized_official_last_name": "GARNER",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRES./CEO",
        "authorized_official_telephone_number": "260-569-9550",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200421610A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CLI Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2010; 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.