Individual provider Active NPI

Elvis Surles, OD

  • Optometrist
  • Monroe, LA
National Provider Identifier
1265409510
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
717127T Issued in LA
Practice address
2209 Forsythe Ave
Monroe, LA 71201
Phone
(318) 387-5657
Fax
(318) 325-8472
NPI assigned
Mar 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 717127T LA Primary

Addresses

Primary practice location

2209 Forsythe Ave
Monroe, LA 71201

Mailing address

2209 Forsythe Ave
Monroe, LA 71201
Phone (318) 387-5657

Other identifiers 2

IdentifierTypeStateIssuer
49455OtherPIN #
1946192MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110308000418 LA Practitioner - Optometry 2163603002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
717127TLAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Moss Eye Care, LLC Optometrist CurrentSince Dec 29, 2014 Accepting new patients

Locations

2209 Forsythe Ave
Monroe, LA 71201
Phone (318) 387-5657

3300 Sterlington Rd
Monroe, LA 71203
Phone (318) 387-5657

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1265409510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2209 FORSYTHE AVE",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "71201",
            "telephone_number": "318-387-5657",
            "fax_number": "318-325-8471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2209 FORSYTHE AVE",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "71201",
            "telephone_number": "318-387-5657",
            "fax_number": "318-325-8472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURLES",
        "first_name": "ELVIS",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-07",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "LA",
            "license": "717127T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PIN #",
            "identifier": "49455",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1946192",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

Verify at the official NPI Registry.