NPIMap

Organization Active NPI

Wooster Ophthalmologists, Inc.

Doing business as Eye Surgery Center of Wooster

  • Ambulatory Surgical Clinic/Center
  • Wooster, OH
National Provider Identifier
1265462881
Registry record updated Mar 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
ID#0374AS Issued in OH
Legal business name
WOOSTER OPHTHALMOLOGISTS, INC.
Doing business as
Eye Surgery Center of Wooster
Practice address
3519 Friendsville Rd
Wooster, OH 44691-1241
Phone
(330) 345-7200
Fax
(330) 345-8029
NPI assigned
Jul 3, 2006
Last updated
Mar 6, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
WOOSTER OPHTHALMOLOGISTS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 6, 2023

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

Authorized official

Name
Jeffrey W Perkins, M.D.NPI 1346269958
Title
Ceo
Phone
(330) 345-7200

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
Ambulatory Surgical Clinic/Center 261QA1903X ID#0374AS OH Primary

Addresses

Primary practice location

3519 Friendsville Rd
Wooster, OH 44691-1241

Mailing address

3519 Friendsville Rd
Wooster, OH 44691-1241
Phone (330) 345-7200

Other identifiers 1

IdentifierTypeStateIssuer
0964283MedicaidOH

Other names 1

  • Eye Surgery Center of Wooster Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090528000028 OH Part B Supplier - Ambulatory Surgical Center 5395740807 Practice locations: Wooster, OH

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Eye Surgery Center of WoosterCCN 36C0001050
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
36D0881182Eye Surgery Center of Wooster3519 Friendsville Road, Wooster, OH 44691Certificate of waiverJan 4, 2028

National Provider Directory

National Provider Directory
Tax ID family
Wooster Ophthalmologists Inc2 organizations share this tax ID, including this one
Part of
Wooster Ophthalmologists Inc

Other organizations with this tax ID 1

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

Locations

3519 Friendsville Rd
#O
Wooster, OH 44691

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678060800000",
    "number": "1265462881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3519 FRIENDSVILLE RD",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446911241",
            "telephone_number": "330-345-7200",
            "fax_number": "330-345-8029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3519 FRIENDSVILLE RD",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446911241",
            "telephone_number": "330-345-7200",
            "fax_number": "330-345-8029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOOSTER OPHTHALMOLOGISTS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WOOSTER OPHTHALMOLOGISTS, INC.",
        "enumeration_date": "2006-07-03",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A",
        "authorized_official_last_name": "PERKINS",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "330-345-7200",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "OH",
            "license": "ID#0374AS",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0964283",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eye Surgery Center of Wooster",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Eye Surgery Center of Wooster",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wooster, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2023; 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.