Colonie ASC LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

COLONIE ASC LLC

Doing business as

Specialty Eye Surgery & Laser Center of the Capital Region

Practice address

207 Troy-Schenectady Rd
Colonie, NY 12110

Phone

(518) 423-7784

NPI assigned

Oct 25, 2016

Last updated

Mar 12, 2020By 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

Dr. Edward J Wladis, MD

Title

Medical Director

Phone

(518) 423-7784

Specialties & licenses 1

Addresses

Other names 1

• Specialty Eye Surgery & Laser Center of the Capital Region Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

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

• Colonie ASC LLC

  • Certified Registered Nurse Anesthetist
  • Latham, NY
  • NPI 1013883982

  2860766086

  Same PAC ID

Listed as

Colonie ASC LLC Dba Specialty Eye Surgery and Laser Center of the Capital RegionCCN 33C0001175

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Tax ID family

Colonie ASC LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Colonie ASC LLC

  • Certified Registered Nurse Anesthetist
  • Latham, NY
  • NPI 1013883982
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Colonie ASC LLC

  • Certified Registered Nurse Anesthetist
  • Latham, NY
  • NPI 1013883982
  NPPES parent name

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.

• Robert L Schultze, M.D.

  • Ophthalmology Physician
  • Slingerlands, NY
  • NPI 1417933540
  NPD

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

{
    "created_epoch": "1477353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583971200000",
    "number": "1316499452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 TROY SCHENECTADY RD",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121105446",
            "telephone_number": "518-538-9128",
            "fax_number": "518-389-2933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 TROY-SCHENECTADY RD",
            "city": "COLONIE",
            "state": "NY",
            "postal_code": "12110",
            "telephone_number": "518-423-7784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLONIE ASC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-25",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A",
        "authorized_official_last_name": "WLADIS",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "518-423-7784",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Specialty Eye Surgery & Laser Center of the Capital Region",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ambulatory Surgical Clinic/Center in Colonie, NY
• Providers in Colonie, NY by specialty
• Ambulatory Surgical Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2020; 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.