NPIMap

Organization Active NPI

Novamed Eye Surgery Center of Overland Park, LLC

Doing business as Overland Park Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Overland Park, KS
National Provider Identifier
1629078043
Registry record updated Oct 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
S-046-005 Issued in KS
Legal business name
NOVAMED EYE SURGERY CENTER OF OVERLAND PARK, LLC
Doing business as
Overland Park Surgery Center
Practice address
5520 College Blvd
Suite 200
Overland Park, KS 66211-1630
Phone
(913) 491-3040
Fax
(913) 491-3640
NPI assigned
Jul 28, 2005
Last updated
Oct 13, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2020

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

Authorized official

Name
Jennifer Boyd Baldock
Title
Officer and Authorized Official
Phone
(615) 234-5900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X S-046-005 KS Primary

Addresses

Primary practice location

5520 College Blvd
Suite 200
Overland Park, KS 66211-1630

Mailing address

5520 College Blvd
Suite 200
Overland Park, KS 66211-1630
Phone (913) 491-3040

Other names 1

  • Overland Park Surgery Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040401000173 KS Part B Supplier - Ambulatory Surgical Center 7012909872 Practice locations: Overland Park, KS
O20051109001232 KS Part B Supplier - Clinic/Group Practice 7012909872 Receives reassigned benefits from 31 practitioners
1 other NPI on this enrollment
Practice locations: Overland Park, KS

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Novamed Eye Surgery Center of Overland Park LLCCCN 17C0001010
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Novamed Eye SRG Ctrov PK Prof Fee2 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.

Locations

12239 Collections Cntr Dr
Chicago, IL 60693

Practitioners & affiliated clinicians

Practitioners 33

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 33

NPI Registry JSON

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602547200000",
    "number": "1629078043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5520 COLLEGE BLVD",
            "address_2": "SUITE 200",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111630",
            "telephone_number": "913-491-3040",
            "fax_number": "913-491-3640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5520 COLLEGE BLVD",
            "address_2": "SUITE 200",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111630",
            "telephone_number": "913-491-3040",
            "fax_number": "913-491-3640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVAMED EYE SURGERY CENTER OF OVERLAND PARK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-28",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A",
        "authorized_official_last_name": "BALDOCK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "BOYD",
        "authorized_official_title_or_position": "OFFICER AND AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "615-234-5900"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "KS",
            "license": "S-046-005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Overland Park Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Overland Park Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2020; 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.