Organization Active NPI

Ophthalmology Surgical Center, Inc

Doing business as Ophthalmology Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Harrisburg, PA
National Provider Identifier
1174525521
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
OPHTHALMOLOGY SURGICAL CENTER, INC
Doing business as
Ophthalmology Surgery Center
Practice address
92 Tuscarora St
2ND Floor
Harrisburg, PA 17104-1667
Phone
(717) 233-2020
Fax
(717) 233-0825
NPI assigned
Aug 15, 2005
Last updated
May 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Authorized official

Name
Mrs. Cambria Krovic
Title
Managed Care Contract Specialist
Phone
(717) 233-2020

Specialties & licenses 1

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

Addresses

Primary practice location

92 Tuscarora St
2ND Floor
Harrisburg, PA 17104-1667

Mailing address

92 Tuscarora St
2ND Floor
Harrisburg, PA 17104-1667
Phone (717) 233-2020

Other identifiers 1

IdentifierTypeStateIssuer
1473012MedicaidPA

Other names 1

  • Ophthalmology Surgery Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061129000513 PA Part B Supplier - Ambulatory Surgical Center 4587662556 Practice locations: Harrisburg, PA

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Ophthalmology Surgical Center IncCCN 39C0001051
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
39D0898158Ophthalmology Surgical Center Inc92 Tuscarora Street, 2ND FLR, Harrisburg, PA 17104Certificate of waiverFeb 22, 2027

National Provider Directory

National Provider Directory

Locations

92 Tuscarora St
Fl 2
Harrisburg, PA 17104
Phone (717) 233-2020

92 Tuscarora St
Ste 2
Harrisburg, PA 17104

Practitioners & affiliated clinicians

Practitioners 2

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": "1124064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715212800000",
    "number": "1174525521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 TUSCARORA ST",
            "address_2": "2ND FLOOR",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171041667",
            "telephone_number": "717-233-2020",
            "fax_number": "717-233-0825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 TUSCARORA ST",
            "address_2": "2ND FLOOR",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171041667",
            "telephone_number": "717-233-2020",
            "fax_number": "717-233-0825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPHTHALMOLOGY SURGICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-15",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A",
        "authorized_official_last_name": "KROVIC",
        "authorized_official_first_name": "CAMBRIA",
        "authorized_official_title_or_position": "MANAGED CARE CONTRACT SPECIALIST",
        "authorized_official_telephone_number": "717-233-2020",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1473012",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ophthalmology Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Harrisburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; 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.