NPIMap

Organization Active NPI

Pacific Cataract and Laser Institute Inc PC

  • Ambulatory Surgical Clinic/Center
  • Chehalis, WA
National Provider Identifier
1487821633
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
601061994 Issued in WA
Legal business name
PACIFIC CATARACT AND LASER INSTITUTE INC PC
Practice address
2517 NE Kresky Ave
Chehalis, WA 98532
Phone
(360) 748-8632
Fax
(360) 807-7687
NPI assigned
May 15, 2008
Last updated
Jul 18, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Authorized official

Name
Debbie J Eldredge
Title
VP / Coo
Phone
(360) 748-8632

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 601061994 WA Primary
Ophthalmologic Surgery Clinic/Center 261QS0132X 601061994 WA

Addresses

Primary practice location

2517 NE Kresky Ave
Chehalis, WA 98532

Mailing address

PO Box 1506
Chehalis, WA 98532-0409
Phone (360) 242-3008

Other identifiers 1

IdentifierTypeStateIssuer
7020712MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040213000312 WA Part B Supplier - Clinic/Group Practice 7517864119 Receives reassigned benefits from 73 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lacey, WA; Yakima, WA; Vancouver, WA; Tacoma, WA; Spokane Valley, WA; Silverdale, WA; Kennewick, WA; Chehalis, WA…
O20120807000943 WA Part B Supplier - Ambulatory Surgical Center 7517864119 Practice locations: Chehalis, WA

Other NPIs with the same Medicare PAC ID 14

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

View all 14

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Pacific Cataract and Laser Institute Inc PCCCN 50C0001011
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Pacific Cataract and Laser Institute Inc PC12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Practitioners & affiliated clinicians

Practitioners 81

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.

View all 81

NPI Registry JSON

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

{
    "created_epoch": "1210809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658102400000",
    "number": "1487821633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1506",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985320409",
            "telephone_number": "360-242-3008",
            "fax_number": "360-807-7687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2517 NE KRESKY AVE",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "98532",
            "telephone_number": "360-748-8632",
            "fax_number": "360-807-7687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC CATARACT AND LASER INSTITUTE INC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-15",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A",
        "authorized_official_last_name": "ELDREDGE",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VP / COO",
        "authorized_official_telephone_number": "360-748-8632"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "WA",
            "license": "601061994",
            "primary": true
        },
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": "WA",
            "license": "601061994",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7020712",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chehalis, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2022; 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.