NPIMap

Organization Active NPI

Columbia Eye Surg Center Inc

  • Ophthalmologic Surgery Clinic/Center
  • Columbia, SC
National Provider Identifier
1184686792
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmologic Surgery Clinic/CenterTaxonomy code 261QS0132X
License
ASF018 Issued in SC
Legal business name
COLUMBIA EYE SURG CENTER INC
Practice address
1920 Pickens St
Columbia, SC 29201-2632
Phone
(803) 779-3070
Fax
(803) 771-7639
NPI assigned
Apr 6, 2006
Last updated
Nov 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Authorized official

Name
Jose A Rodriguez, APRNNPI 1093390775
Title
Nursing Director, Manager
Phone
(803) 254-7732

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmologic Surgery Clinic/Center 261QS0132X ASF018 SC Primary

Addresses

Primary practice location

1920 Pickens St
Columbia, SC 29201-2632

Mailing address

PO Box 60251
Charlotte, NC 28260-0251
Phone (803) 779-3070

Other identifiers 1

IdentifierTypeStateIssuer
410166MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060510000584 SC Part B Supplier - Ambulatory Surgical Center 8325943574 Receives reassigned benefits from 4 practitioners
Practice locations: Columbia, SC

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Columbia Eye Surgery Center IncCCN 42C0001016
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

100 Palmetto Park Blvd
Lexington, SC 29072
Phone (803) 806-0075

Practitioners & affiliated clinicians

Practitioners 21

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 21

NPI Registry JSON

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732060800000",
    "number": "1184686792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60251",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600251",
            "telephone_number": "803-779-3070",
            "fax_number": "803-771-7639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 PICKENS ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012632",
            "telephone_number": "803-779-3070",
            "fax_number": "803-771-7639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA EYE SURG CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-06",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "NURSING DIRECTOR, MANAGER",
        "authorized_official_telephone_number": "803-254-7732",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": "SC",
            "license": "ASF018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "410166",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.