Organization Active NPI

Cataract & Laser Center West, LLC

  • Ophthalmology Physician
  • West Springfield, MA
National Provider Identifier
1114091501
Registry record updated Jan 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
CATARACT & LASER CENTER WEST, LLC
Practice address
171 Interstate Dr
Suite #1
West Springfield, MA 01089-5101
Phone
(413) 737-5500
Fax
(413) 732-3514
NPI assigned
Nov 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2016

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

Authorized official

Name
C Michael Duca
Title
Administrator
Phone
(413) 737-5500

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary
Ambulatory Surgical Clinic/Center 261QA1903X AJ4C MA

Addresses

Primary practice location

171 Interstate Dr
Suite #1
West Springfield, MA 01089-5101

Mailing address

171 Interstate Dr
Suite #1
West Springfield, MA 01089-5101
Phone (413) 737-5500

Other identifiers 2

IdentifierTypeStateIssuer
1850288MedicaidMA
CAM88012OtherMABCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100823000810 MA Part B Supplier - Ambulatory Surgical Center 2365576642 Practice locations: West Springfield, MA

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Cataract and Laser Center West LLCCCN 22C0001023
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
22D0913831Cataract & Laser Center West TLLC171 Interstate Dr, West Springfield, MA 01089Certificate of waiverApr 11, 2028

National Provider Directory

National Provider Directory

Locations

171 Interstate Dr
West Springfield, MA 01089
Phone (413) 732-2333

Practitioners & affiliated clinicians

Practitioners 5

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": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451952000000",
    "number": "1114091501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 INTERSTATE DR",
            "address_2": "SUITE #1",
            "city": "WEST SPRINGFIELD",
            "state": "MA",
            "postal_code": "010895101",
            "telephone_number": "413-737-5500",
            "fax_number": "413-732-3514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 INTERSTATE DR",
            "address_2": "SUITE #1",
            "city": "WEST SPRINGFIELD",
            "state": "MA",
            "postal_code": "010895101",
            "telephone_number": "413-737-5500",
            "fax_number": "413-732-3514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATARACT & LASER CENTER WEST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2016-01-05",
        "status": "A",
        "authorized_official_last_name": "DUCA",
        "authorized_official_first_name": "C MICHAEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "413-737-5500"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MA",
            "license": "AJ4C",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1850288",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "CAM88012",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Springfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2016; 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.