Humboldt Physicians Surgery and Laser Center LLC

Primary specialty

Ophthalmologic Surgery Clinic/CenterTaxonomy code 261QS0132X

Legal business name

HUMBOLDT PHYSICIANS SURGERY AND LASER CENTER LLC

Practice address

3226 Timber Fall Court
Eureka, CA 95503-4888

Phone

(707) 443-9777

Fax

(707) 445-1003

NPI assigned

May 26, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Gregory N Gibb, M.D.NPI 1467410829

Title

1St Authorized Official

Phone

(707) 443-9777

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Humboldt Physicians Surgery and Laser Center LLCCCN 05C0001906

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

Locations

Practitioners 5

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

• Gregory N Gibb, MD

  • Ophthalmology Physician
  • Eureka, CA
  • NPI 1467410829
  NPD Authorized official
• Dipali V Apte, MD, PHD

  • Glaucoma Specialist (Ophthalmology) Physician
  • San Jose, CA
  • NPI 1528145455
  NPD (past)
• Erik J Jansson, MD

  • Ophthalmology Physician
  • Arcata, CA
  • NPI 1659338788
  NPD (past)
• Christopher Lin, MD, FACS

  • Ophthalmology Physician
  • Eureka, CA
  • NPI 1811982291
  NPD (past)
• John S Mastroni, MD

  • Ophthalmology Physician
  • Eureka, CA
  • NPI 1568420008
  NPD (past)

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

{
    "created_epoch": "1243296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243296000000",
    "number": "1447485156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2840 O'NEIL LANE",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955034870",
            "telephone_number": "707-443-9777",
            "fax_number": "707-445-1003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3226 TIMBER FALL COURT",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955034888",
            "telephone_number": "707-443-9777",
            "fax_number": "707-445-1003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMBOLDT PHYSICIANS SURGERY AND LASER CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-26",
        "last_updated": "2009-05-26",
        "status": "A",
        "authorized_official_last_name": "GIBB",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "1ST AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "707-443-9777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Humboldt Medical Specialists, Inc
• Humboldt Mobile Massage, Inc
• Humboldt Neurological Medical Group Inc
• Humboldt Orthopaedic Medical Associates, Inc.
• Humboldt Orthopaedic Medical Associates, Inc.
• Humboldt Radiology Medical Group Inc
• Humboldt Radiology Medical Group Inc
• Humboldt Radiology Medical Group Inc
• Humboldt Radiology Medical Group Inc.
• Humboldt Recovery Center Inc.,

• Ophthalmologic Surgery Clinic/Center in Eureka, CA
• Providers in Eureka, CA by specialty
• Ophthalmologic Surgery Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2009; 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.