Eagle Eye Surgery and Laser Center LLC
Organization Active NPI Ambulatory Surgical Clinic/Center · Meridian, ID
NPI 1235255605 · NPPES record last updated Sep 8, 2026
Key facts
- NPI
- 1235255605
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulatory Surgical Clinic/Center 261QA1903X
- Legal business name
- EAGLE EYE SURGERY AND LASER CENTER LLC
- Practice address
- 3090 E Gentry Way Ste 100
Meridian, ID 83642-3548 - Phone
- (208) 288-1600
- Fax
- (208) 288-4299
- NPI assigned
- Mar 21, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. Jeffrey Snodgrass
- Title
- President
- Phone
- (615) 665-1283
Medicare Care Compare: Ambulatory surgical center
- Listed as
- Eagle Eye Surgery and Laser Center
- Medicare certification status
- Active
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 13D0976451 | Eagle Eye Surgery and Laser Center | Certificate of waiver | Aug 3, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100123000215 | ID | Part B Supplier - Ambulatory Surgical Center | 9739221151 | Practice locations: Meridian, ID |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | Yes |
Addresses
Primary practice location
3090 E Gentry Way Ste 100
Meridian, ID 83642-3548
Mailing address
1A Burton Hills Blvd Ste 300
Attn: L&C
Nashville, TN 37215-6153
Phone (615) 665-1283
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000010029603 | Other | ID | REGENCE BLUE SHIELD |
| 805834800 | Medicaid | ID | |
| 04093 | Other | ID | BLUE CROSS |
| 150695 | Medicaid | OR | |
| 490004716 | Other | ID | RAILROAD MEDICARE |
Other names
- Eagle Eye Surgery & Laser Center
Other providers in Meridian, ID
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- Eagle Smiles Dentistry and Orthodontics, PC
- Eamesco PC
- East Meets West Medical LLC
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All providers in Meridian, ID · Ambulatory Surgical Clinic/Center in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 8, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.