Organization Active NPI

Laser Vision USA, Inc.

  • Ophthalmology Physician
  • Anchorage, AK
National Provider Identifier
1407969249
Registry record updated Jan 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
4540 Issued in AK
Legal business name
LASER VISION USA, INC.
Practice address
235 E 8TH Ave Ste 3a
Anchorage, AK 99501-3662
Phone
(907) 569-1551
Fax
(907) 569-1564
NPI assigned
Aug 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2011

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

Authorized official

Name
Dr. Eric W Coulter, M.D.NPI 1871606681
Title
President
Phone
(907) 569-1551

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
Ophthalmology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207W00000X 4540 AK Primary

Addresses

Primary practice location

235 E 8TH Ave Ste 3a
Anchorage, AK 99501-3662

Mailing address

235 E 8TH Ave Ste 3a
Anchorage, AK 99501-3662
Phone (907) 569-1551

Other identifiers 3

IdentifierTypeStateIssuer
205382205382OtherAKBLUE CROSS BLUE SHIELD
GRP4536OtherAKPROVIDENCE HEALTH PLANS
MD2963MedicaidAK

Other names 1

  • Alaska Lasik Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040303000585 AK Part B Supplier - Clinic/Group Practice 9133016165 Receives reassigned benefits from 4 practitioners
Practice locations: Anchorage, AK

National Provider Directory

National Provider Directory

Locations

235 E 8th Ave
Ste 3A
Anchorage, AK 99501
Phone (907) 569-1551

3601 C St
Ste 1134
Anchorage, AK 99503
Phone (907) 569-1551

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295827200000",
    "number": "1407969249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 E 8TH AVE STE 3A",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995013662",
            "telephone_number": "907-569-1551",
            "fax_number": "907-569-1564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 E 8TH AVE STE 3A",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995013662",
            "telephone_number": "907-569-1551",
            "fax_number": "907-569-1564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LASER VISION USA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2011-01-24",
        "status": "A",
        "authorized_official_last_name": "COULTER",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "907-569-1551",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "AK",
            "license": "4540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "205382205382",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDENCE HEALTH PLANS",
            "identifier": "GRP4536",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD2963",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alaska Lasik Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.