Organization Active NPI

Surgical Precision Eye LLC

  • Glaucoma Specialist (Ophthalmology) Physician
  • Georgetown, SC
National Provider Identifier
1124841705
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Glaucoma Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0009X
Legal business name
SURGICAL PRECISION EYE LLC
Practice address
1007 N Fraser St
Georgetown, SC 29440-2848
Phone
(281) 217-3894
NPI assigned
Nov 4, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Authorized official

Name
Dr. Tala Kassm, D.O.NPI 1760800916
Title
Owner
Phone
(281) 217-3894

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X
Glaucoma Specialist (Ophthalmology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207WX0009X Primary
Retina Specialist (Ophthalmology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207WX0107X

Addresses

Primary practice location

1007 N Fraser St
Georgetown, SC 29440-2848

Mailing address

19 Carolina St
Charleston, SC 29403-4787

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250407003244 SC Part B Supplier - Clinic/Group Practice 1557885951 Receives reassigned benefits from 3 practitioners
Practice locations: Georgetown, SC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1730678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730678400000",
    "number": "1124841705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 CAROLINA ST",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294034787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 N FRASER ST",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294402848",
            "telephone_number": "281-217-3894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL PRECISION EYE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-04",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A",
        "authorized_official_last_name": "KASSM",
        "authorized_official_first_name": "TALA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-217-3894",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207WX0009X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology, Glaucoma Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology, Retina Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; 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.