NPIMap

Organization Active NPI

Pacific Cataract and Laser Institute, Inc., P.C.

  • Ambulatory Surgical Clinic/Center
  • Chehalis, WA
National Provider Identifier
1114978848
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
PACIFIC CATARACT AND LASER INSTITUTE, INC., P.C.
Practice address
2517 NE Kresky Ave
Chehalis, WA 98532
Phone
(360) 748-8632
Fax
(360) 748-3869
NPI assigned
May 15, 2006
Last updated
Jul 18, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Authorized official

Name
Darla Pearson
Title
Credentialing Specialist
Phone
(360) 242-3008

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 601 061 994 WA
Ambulatory Surgical Clinic/Center 261QA1903X Primary
Ophthalmologic Surgery Clinic/Center 261QS0132X 601 061 994 WA

Addresses

Primary practice location

2517 NE Kresky Ave
Chehalis, WA 98532

Mailing address

PO Box 1506
Chehalis, WA 98532-0409
Phone (360) 242-3008

Other identifiers 23

IdentifierTypeStateIssuer
7144132MedicaidWA
7144157MedicaidWA
G319000002OtherMEDICARE WA
G8853417OtherWAMEDICARE WA
GAB19549OtherWAMEDICARE WA
7144215MedicaidWA
1870164OtherIDMEDICARE ID
7144181MedicaidWA
R147241OtherORMEDICARE OR
G000355050OtherWAMEDICARE WA
G8893457OtherWAMEDICARE WA
G8895424OtherWAMEDICARE WA
7020712MedicaidWA
GAB22210OtherWAMEDICARE WA
G0001615100OtherWAMEDICARE WA
G8858043OtherWAMEDICARE WA
M00005708OtherMTMEDICARE MT
7144173MedicaidWA
G000100608OtherWAMEDICARE WA
NMB2242OtherNMMEDICARE NM
R108010OtherORMEDICARE OR
7144165MedicaidWA
GAB22179OtherWAMEDICARE WA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address asc.pclichehalis.p1@direct.pcli.nextgenshare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, MT, ID6 enrollments

Enrollment records 6

Enrollment IDStateProvider typePAC IDDetails
O20040213000312 WA Part B Supplier - Clinic/Group Practice 7517864119 Receives reassigned benefits from 73 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lacey, WA; Yakima, WA; Vancouver, WA; Tacoma, WA; Spokane Valley, WA; Silverdale, WA; Kennewick, WA; Chehalis, WA…
O20040213000339 WA Part B Supplier - Ambulatory Surgical Center 7517864119 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Silverdale, WA
O20040816000723 MT Part B Supplier - Clinic/Group Practice 7517864119 Receives reassigned benefits from 25 practitioners
1 other NPI on this enrollment
Practice locations: Great Falls, MT
O20040910000914 ID Part B Supplier - Clinic/Group Practice 7517864119 Receives reassigned benefits from 43 practitioners
Practice locations: Boise, ID; Lewiston, ID
O20050211000861 ID Part B Supplier - Ambulatory Surgical Center 7517864119 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lewiston, ID
O20180818000018 ID Part B Supplier - Ambulatory Surgical Center 7517864119 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Boise, ID

Other NPIs with the same Medicare PAC ID 14

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

View all 14

Other NPIs on the same Medicare enrollment 14

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

View all 14

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: asc.pclichehalis.p1@direct.pcli.nextgenshare.com

Practitioners & affiliated clinicians

Practitioners 75

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 75

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658102400000",
    "number": "1114978848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1506",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985320409",
            "telephone_number": "360-242-3008",
            "fax_number": "360-807-7687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2517 NE KRESKY AVE",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "98532",
            "telephone_number": "360-748-8632",
            "fax_number": "360-748-3869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC CATARACT AND LASER INSTITUTE, INC., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A",
        "authorized_official_last_name": "PEARSON",
        "authorized_official_first_name": "DARLA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "360-242-3008"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "WA",
            "license": "601 061 994",
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": "WA",
            "license": "601 061 994",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7144132",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7144157",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE WA",
            "identifier": "G319000002",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE WA",
            "identifier": "G8853417",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE WA",
            "identifier": "GAB19549",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7144215",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "1870164",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7144181",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE OR",
            "identifier": "R147241",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE WA",
            "identifier": "G000355050",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE WA",
            "identifier": "G8893457",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE WA",
            "identifier": "G8895424",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7020712",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE WA",
            "identifier": "GAB22210",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE WA",
            "identifier": "G0001615100",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE WA",
            "identifier": "G8858043",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE MT",
            "identifier": "M00005708",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7144173",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE WA",
            "identifier": "G000100608",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NM",
            "identifier": "NMB2242",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE OR",
            "identifier": "R108010",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7144165",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE  WA",
            "identifier": "GAB22179",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "asc.pclichehalis.p1@direct.pcli.nextgenshare.com",
            "affiliation": "N",
            "address_1": "2517 NE Kresky Ave",
            "city": "Chehalis",
            "state": "WA",
            "country_code": "US",
            "postal_code": "98532",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chehalis, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.