Eye Surgery Center

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

07-1500 Issued in OR

Legal business name

EYE SURGERY CENTER

Practice address

1408 E Barnett Rd
Medford, OR 97504

Phone

(541) 779-2020

Fax

(541) 770-6838

NPI assigned

Mar 2, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Janice Dawn Boucher

Title

Business Manager

Phone

(541) 779-2020

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Loren Barrus & Paul Schultz PTRS Other name

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Listed as

Eye Surgery CenterCCN 38C0001004

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Clara Miluska Castillejo Becerra, MD

  • Ophthalmology Physician
  • Medford, OR
  • NPI 1770112476
  Medicare reassignment NPD
• David Edmund Cink, M.D.

  • Specialist
  • Medford, OR
  • NPI 1518942283
  Medicare reassignment NPD
• Allison Rae Jarstad, DO

  • Ophthalmology Physician
  • Medford, OR
  • NPI 1265729081
  Medicare reassignment NPD
• Justin Matthew Spaulding, D.O.

  • Glaucoma Specialist (Ophthalmology) Physician
  • Medford, OR
  • NPI 1013259167
  Medicare reassignment NPD

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600387200000",
    "number": "1659409241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1408 E BARNETT RD",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048279",
            "telephone_number": "541-779-2020",
            "fax_number": "541-770-6838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1408 E BARNETT RD",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "97504",
            "telephone_number": "541-779-2020",
            "fax_number": "541-770-6838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-02",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-18",
        "status": "A",
        "authorized_official_last_name": "BOUCHER",
        "authorized_official_first_name": "JANICE",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "541-779-2020",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "OR",
            "license": "07-1500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110684",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Loren Barrus & Paul Schultz PTRS",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Loren Barrus & Paul Schultz PTRS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Every Word Counts
• Thomas M Ewald, MD
• Angela R Ewing, LPC
• Denise Kesti Ewing, RN
• Expert Mobility LLC
• Eyecare Associates of Southern Oregon PC
• Eyemart Express LLC
• Eyemart Express, LTD.
• Matthew Alan Eykelbosch, MS, MDIV, LPC
• Terri B Fagan, FNP

• Ambulatory Surgical Clinic/Center in Medford, OR
• Providers in Medford, OR by specialty
• Ambulatory Surgical Clinic/Center in Oregon

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