NPIMap

Organization Active NPI

Pacific Cataract and Laser Institute Inc PC

  • Ambulatory Surgical Clinic/Center
  • Bellingham, WA
National Provider Identifier
1194047092
Registry record updated Nov 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
601061994 Issued in WA
Legal business name
PACIFIC CATARACT AND LASER INSTITUTE INC PC
Practice address
4330 Mitchell Way
Bellingham, WA 98226
Phone
(360) 736-6860
Fax
(360) 738-6853
NPI assigned
Feb 18, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2020

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 601061994 WA Primary

Addresses

Primary practice location

4330 Mitchell Way
Bellingham, WA 98226

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
1194047092MedicaidWA

Electronic endpoints 1

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments

Enrollment records 2

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…
O20120807000891 WA Part B Supplier - Ambulatory Surgical Center 7517864119 Practice locations: Bellingham, WA

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 11

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

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Pacific Cataract and Laser Institute Inc PCCCN 50C0001296
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
50D2006317Pacific Cataract and Laser Institute4330 Mitchell Way, Bellingham, WA 98226Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory
Tax ID family
Pacific Cataract and Laser Institute Inc PC12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 9

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": "1266451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606089600000",
    "number": "1194047092",
    "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": "4330 MITCHELL WAY",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "98226",
            "telephone_number": "360-736-6860",
            "fax_number": "360-738-6853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC CATARACT AND LASER INSTITUTE INC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-18",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "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": "601061994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194047092",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "asc.pclibellingham.p1@direct.pcli.nextgenshare.com",
            "affiliation": "N",
            "address_1": "4330 Mitchell Way",
            "city": "Bellingham",
            "state": "WA",
            "country_code": "US",
            "postal_code": "98226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; 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.