NPIMap

Organization Active NPI

Eye Surgery Center of New Albany, LLC

  • Certified Registered Nurse Anesthetist
  • New Albany, IN
National Provider Identifier
1619119294
Registry record updated Jan 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
EYE SURGERY CENTER OF NEW ALBANY, LLC
Practice address
520 W 1St St
New Albany, IN 47150-3603
Phone
(812) 949-3442
Fax
(812) 949-3441
NPI assigned
Mar 30, 2009
Last updated
Jan 4, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
EYE SURGERY CENTER OF NEW ALBANY, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 4, 2021

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

Authorized official

Name
Mr. Kelly McCrann Jr.
Title
Ceo
Phone
(812) 949-3442

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NU Primary

Addresses

Primary practice location

520 W 1St St
New Albany, IN 47150-3603

Mailing address

520 W 1St St
New Albany, IN 47150-3603
Phone (812) 949-3442

Other identifiers 1

IdentifierTypeStateIssuer
7100207620MedicaidKY

Other names 1

  • NovaMed Eye Surgery Center of New Albany, LLC Former legal business name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address donaldlenz@eyesurgeryna.com Direct
Direct Messaging Address rebeccareed@eyesurgeryna.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040212000733 IN Part B Supplier - Ambulatory Surgical Center 1759275381 Receives reassigned benefits from 8 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: New Albany, IN

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Part of
Novamed Eye Surgery Cen

Member of 2

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

Locations

7290 Reliable Pkwy
Chicago, IL 60686

1305 Wall St
#101
Jeffersonvlle, IN 47130
Phone (812) 288-9674

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 12

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": "1238371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609718400000",
    "number": "1619119294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 W 1ST ST",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471503603",
            "telephone_number": "812-949-3442",
            "fax_number": "812-949-3441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 W 1ST ST",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471503603",
            "telephone_number": "812-949-3442",
            "fax_number": "812-949-3441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE SURGERY CENTER OF NEW ALBANY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EYE SURGERY CENTER OF NEW ALBANY, LLC",
        "enumeration_date": "2009-03-30",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A",
        "authorized_official_last_name": "MCCRANN",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "812-949-3442",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100207620",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "donaldlenz@eyesurgeryna.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "520 W 1st St",
            "city": "New Albany",
            "state": "IN",
            "country_code": "US",
            "postal_code": "471503603",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rebeccareed@eyesurgeryna.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "520 W 1st St",
            "city": "New Albany",
            "state": "IN",
            "country_code": "US",
            "postal_code": "471503603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "NovaMed Eye Surgery Center of New Albany, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in New Albany, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.