Eye MD Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

EYE MD SURGERY CENTER LLC

Practice address

14 Vision St Ste 200
Bethlehem, GA 30620-1769

Phone

(770) 868-0101

NPI assigned

Jul 23, 2022

Last updated

Dec 22, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Manan Shah, MDNPI 1881621233

Title

Physician

Phone

(770) 868-0101

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

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.

• Manan I Shah, MD

  • Ophthalmology Physician
  • Bethlehem, GA
  • NPI 1881621233
  NPD Authorized official

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

{
    "created_epoch": "1658534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671667200000",
    "number": "1306571278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 VISION ST STE 200",
            "city": "BETHLEHEM",
            "state": "GA",
            "postal_code": "306201769",
            "telephone_number": "770-868-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 VISION ST STE 200",
            "city": "BETHLEHEM",
            "state": "GA",
            "postal_code": "306201769",
            "telephone_number": "770-868-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE MD SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-23",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "MANAN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "770-868-0101",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Bethlehem, GA
• Providers in Bethlehem, GA by specialty
• Ambulatory Surgical Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2022; 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.