Florida Eye Institute Surgicenter LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

859 Issued in FL

Legal business name

FLORIDA EYE INSTITUTE SURGICENTER LLC

Practice address

2750 Indian River Blvd
Vero Beach, FL 32960-5225

Phone

(772) 569-9500

Fax

(772) 569-9507

NPI assigned

Jun 20, 2006

Last updated

Jun 7, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Mary Lynne Macdonald

Title

Administrator

Phone

(772) 569-9500

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Listed as

Florida Eye Institute SurgicenterCCN 10C0001059

Medicare certification status

ActiveFrom the Provider of Services file

Tax ID family

Florida Eye Inst Surgicenter2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Florida Eye Institute Surgicenter LLC

  • Anesthesiology Physician
  • Vero Beach, FL
  • NPI 1457189110
  NPD tax ID

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Florida Eye Institute, P.a.

  • Specialist
  • Vero Beach, FL
  • NPI 1053356337

  Member Of

  NPD member

Practitioners 5

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.

• Kelly Colleen Herms, CRNA

  • Certified Registered Nurse Anesthetist
  • Palm City, FL
  • NPI 1083920714
  Medicare reassignment NPD
• Wilfred R Lovelock, CRNA

  • Certified Registered Nurse Anesthetist
  • Melbourne, FL
  • NPI 1124110150
  Medicare reassignment NPD
• Evelyn Denise Moffett, CRNA

  • Certified Registered Nurse Anesthetist
  • Melbourne, FL
  • NPI 1770012379
  Medicare reassignment NPD
• Thomas Anthony Baudo, M.D.

  • Specialist
  • Vero Beach, FL
  • NPI 1205881976
  NPD
• John Valdis Zudans, M.D.

  • Ophthalmology Physician
  • Barefoot Bay, FL
  • NPI 1275572315
  NPD (past)

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717718400000",
    "number": "1598700676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 INDIAN RIVER BLVD",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329605225",
            "telephone_number": "772-569-9500",
            "fax_number": "772-569-9507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 INDIAN RIVER BLVD",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329605225",
            "telephone_number": "772-569-9500",
            "fax_number": "772-569-9507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA EYE INSTITUTE SURGICENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-20",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A",
        "authorized_official_last_name": "MACDONALD",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "772-569-9500",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "FL",
            "license": "859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00055069",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "079122900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL BCBS NO.",
            "identifier": "663",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Florida Care Alf of Vero Beach Inc (Spring Hills Assisted Living Facility)
• Florida Center for Psychiatric Services, PLLC
• Florida Dental Sleep Disorders PA
• Florida Department of Health (Indian River County Health Department)
• Florida Eye Institute Surgicenter LLC
• Florida Eye Institute, P.a.
• Florida Institute for Physical Rehabilitation, P.L.L.C.
• Florida Neuropsychology Group PA
• Florida Physical Therapy & Occupational Therapy LLC
• Florida Respiratory-St Lucie Inc

• Ambulatory Surgical Clinic/Center in Vero Beach, FL
• Providers in Vero Beach, FL by specialty
• Ambulatory Surgical Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2024; 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.