Active NPI
Augusta Retina Laser Surgicare
- Ambulatory Surgical Clinic/Center
- Augusta, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- Legal business name
- AUGUSTA RETINA LASER SURGICARE
- Practice address
- 3685 Wheeler Rd
Suite 202
Augusta, GA 30909-6446 - Phone
- (706) 210-0305
- Fax
- (706) 210-0306
- NPI assigned
- Jan 10, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kevin Becker
- Title
- Cfo
- Phone
- (914) 391-4921
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | GA | Primary |
Addresses
Primary practice location
3685 Wheeler Rd
Suite 202
Augusta, GA 30909-6446
Mailing address
PO Box 11407
Birmingham, AL 35246-8575
Phone (864) 359-1308
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ASC025 | Medicaid | SC | |
| 000874794A | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120228000589 | GA | Part B Supplier - Ambulatory Surgical Center | 7810155462 |
Receives reassigned benefits from 1 practitioner Practice locations: Augusta, GA |
Ambulatory surgical center certification: CCN 11C0001167
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- AUGUSTA RETINA-LASER SURGICARE
- Certification status
- Active
- Provider type (POS)
- Ambulatory surgical center
- Participating since
- Jun 1, 2000
- Last certification
- Nov 14, 2017
- Ownership / control type
- Proprietary
- Facility address
- 3685 Wheeler Road, Suite 202
Augusta, GA 30909
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D0960343 | Augusta Retina-Laser Surgicare | Certificate of waiver | May 6, 2027 |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Ophthalmology Physician
- Augusta, GA
- NPI 1851376776
-
- Ophthalmology Physician
- Augusta, GA
- NPI 1235115890
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136851200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1777248000000",
"number": "1235118043",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 11407",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352468575",
"telephone_number": "864-359-1308",
"fax_number": "239-496-3939"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3685 WHEELER RD",
"address_2": "SUITE 202",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309096446",
"telephone_number": "706-210-0305",
"fax_number": "706-210-0306"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AUGUSTA RETINA LASER SURGICARE",
"organizational_subpart": "NO",
"enumeration_date": "2006-01-10",
"last_updated": "2026-04-27",
"certification_date": "2026-04-27",
"status": "A",
"authorized_official_last_name": "BECKER",
"authorized_official_first_name": "KEVIN",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "914-391-4921"
},
"taxonomies": [
{
"code": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": "GA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ASC025",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000874794A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Augusta, GA
- Augusta Prosthetics & Orthotics Inc
- Augusta Psychiatry and Therapy Associates, LLC
- Augusta Rehabilitation Associates, P.C.
- Augusta Renal Physicians, P.C.
- Augusta Retina Consultants
- Augusta Rheumatology Institute, LLC
- Augusta Sleep Study Solutions, LLC
- Augusta Smiles Youth Dentistry, PC
- Augusta Specialty Hospitalists LLC
- Augusta Surgical Group, P.C.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- 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.