NPIMap

Organization Active NPI

Proliance Surgeons, Inc., P.S.

Doing business as The Retina Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Bellevue, WA
National Provider Identifier
1467721498
Registry record updated Dec 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
PROLIANCE SURGEONS, INC., P.S.
Doing business as
The Retina Surgery Center
Practice address
1750 112TH Ave NE
Suite D-050
Bellevue, WA 98004-3752
Phone
(206) 215-3850
Fax
(206) 215-3870
NPI assigned
Dec 20, 2011
Last updated
Dec 20, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2011

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

Authorized official

Name
Mr. David G. Fitzgerald
Title
Ceo
Phone
(206) 838-2599

Specialties & licenses 1

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

Addresses

Primary practice location

1750 112TH Ave NE
Suite D-050
Bellevue, WA 98004-3752

Mailing address

805 Madison St
Suite 901
Seattle, WA 98104-1172
Phone (206) 264-8100

Other names 1

  • The Retina Surgery Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Proliance Surgeons Inc PS46 organizations share this tax ID, including this one

Other organizations with this tax ID 45

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

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1324339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324339200000",
    "number": "1467721498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 MADISON ST",
            "address_2": "SUITE 901",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041172",
            "telephone_number": "206-264-8100",
            "fax_number": "206-264-8689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 112TH AVE NE",
            "address_2": "SUITE D-050",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043752",
            "telephone_number": "206-215-3850",
            "fax_number": "206-215-3870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROLIANCE SURGEONS, INC., P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-20",
        "last_updated": "2011-12-20",
        "status": "A",
        "authorized_official_last_name": "FITZGERALD",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "206-838-2599",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Retina Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.