NPIMap

Organization Active NPI

Florida Eye Clinic Ambulatory Surgery Center, Inc.

  • Ambulatory Surgical Clinic/Center
  • Altamonte Springs, FL
National Provider Identifier
1376513440
Registry record updated May 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
945 Issued in FL
Legal business name
FLORIDA EYE CLINIC AMBULATORY SURGERY CENTER, INC.
Practice address
160 Boston Avenue
Altamonte Springs, FL 32701-4706
Phone
(407) 834-7776
Fax
(407) 834-0973
NPI assigned
Jan 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2017

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

Authorized official

Name
Dr. Harry R. Pappas, MD
Title
Owner
Phone
(407) 834-7776

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 945 FL Primary

Addresses

Primary practice location

160 Boston Avenue
Altamonte Springs, FL 32701-4706

Mailing address

160 Boston Avenue
Altamonte Springs, FL 32701-4706
Phone (407) 834-7776

Other identifiers 2

IdentifierTypeStateIssuer
062926000MedicaidFL
033553300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040303000192 FL Part B Supplier - Clinic/Group Practice 0749177822 Receives reassigned benefits from 21 practitioners
Practice locations: Altamonte Springs, FL
O20120405000350 FL Part B Supplier - Ambulatory Surgical Center 0749177822 Receives reassigned benefits from 4 practitioners
Practice locations: Altamonte Springs, FL

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Florida Eye Clinic Ambulatory Surgery CenterCCN 10C0001011
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Florida Eye Clinic Ambulatory Surgical Center Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493769600000",
    "number": "1376513440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 BOSTON AVENUE",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327014706",
            "telephone_number": "407-834-7776",
            "fax_number": "407-834-0973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 BOSTON AVENUE",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327014706",
            "telephone_number": "407-834-7776",
            "fax_number": "407-834-0973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA EYE CLINIC AMBULATORY SURGERY CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-23",
        "last_updated": "2017-05-03",
        "status": "A",
        "authorized_official_last_name": "PAPPAS",
        "authorized_official_first_name": "HARRY",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-834-7776",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "FL",
            "license": "945",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "062926000",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "033553300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Altamonte Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2017; 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.