NPIMap

Organization Active NPI

Midwest Eye Consultants, P.C.

Doing business as CLI Surgery Center - South Bend/Mishawaka

  • Ambulatory Surgical Clinic/Center
  • Mishawaka, IN
National Provider Identifier
1467032862
Registry record updated Apr 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
MIDWEST EYE CONSULTANTS, P.C.
Doing business as
CLI Surgery Center - South Bend/Mishawaka
Practice address
4020 Edison Lakes Pkwy
Mishawaka, IN 46545-3420
Phone
(260) 569-9550
NPI assigned
Apr 9, 2021
Last updated
Apr 9, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
MIDWEST EYE CONSULTANTS, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 9, 2021

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

Authorized official

Name
Cathy Garrett
Title
Cao
Phone
(260) 569-9550

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

4020 Edison Lakes Pkwy
Mishawaka, IN 46545-3420

Mailing address

PO Box 549
Wabash, IN 46992-0549
Phone (260) 782-4045

Other names 1

  • CLI Surgery Center - South Bend/Mishawaka Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211207000652 IN Part B Supplier - Ambulatory Surgical Center 2961399217 Practice locations: Mishawaka, IN

Other NPIs with the same Medicare PAC ID 11

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

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Midwest Eye Consultants PC Dba Cli Surgery Center South Bend MishawakaCCN 15C0002006
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D2243741Cli Surgery Center - Southbend/Mishawaka4020 Edison Lakes Parkway, Mishawaka, IN 46545Certificate of waiverNov 21, 2027

National Provider Directory

National Provider Directory
Tax ID family
Midwest Eye Consultants 3428 organizations share this tax ID, including this one
Part of
Midwest Eye Consultants 34

Other organizations with this tax ID 27

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

View all 27

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1617926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617926400000",
    "number": "1467032862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 549",
            "city": "WABASH",
            "state": "IN",
            "postal_code": "469920549",
            "telephone_number": "260-782-4045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4020 EDISON LAKES PKWY",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465453420",
            "telephone_number": "260-569-9550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST EYE CONSULTANTS, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MIDWEST EYE CONSULTANTS, P.C.",
        "enumeration_date": "2021-04-09",
        "last_updated": "2021-04-09",
        "certification_date": "2021-03-19",
        "status": "A",
        "authorized_official_last_name": "GARRETT",
        "authorized_official_first_name": "CATHY",
        "authorized_official_title_or_position": "CAO",
        "authorized_official_telephone_number": "260-569-9550"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CLI Surgery Center - South Bend/Mishawaka",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mishawaka, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2021; 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.