Organization Active NPI

Muncie Cataract & Laser Eye Center, LLC

  • Ophthalmologic Surgery Clinic/Center
  • Muncie, IN
National Provider Identifier
1669477899
Registry record updated Nov 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmologic Surgery Clinic/CenterTaxonomy code 261QS0132X
Legal business name
MUNCIE CATARACT & LASER EYE CENTER, LLC
Practice address
3300 W Purdue Ave
Muncie, IN 47304-6355
Phone
(765) 288-1935
Fax
(765) 289-5032
NPI assigned
Jun 15, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2017

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

Authorized official

Name
Dr. Vasilis Makris, M.D.NPI 1407827678
Title
Medical Director
Phone
(765) 288-1935

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

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

Addresses

Primary practice location

3300 W Purdue Ave
Muncie, IN 47304-6355

Mailing address

3300 W Purdue Ave
Muncie, IN 47304-6355
Phone (765) 288-1935

Other identifiers 2

IdentifierTypeStateIssuer
200382930AMedicaidIN
200316890AMedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050510000283 IN Part B Supplier - Ambulatory Surgical Center 9032159041 Practice locations: Muncie, IN

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Muncie Cataract and Laser Eye Center LLCCCN 15C0001099
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D0975329Muncie Cataract & Laser Eye Center LLC3300 W Purdue Ave, Muncie, IN 47304Certificate of waiverJul 4, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509926400000",
    "number": "1669477899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 W PURDUE AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473046355",
            "telephone_number": "765-288-1935",
            "fax_number": "765-289-5032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 W PURDUE AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473046355",
            "telephone_number": "765-288-1935",
            "fax_number": "765-289-5032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUNCIE CATARACT & LASER EYE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-15",
        "last_updated": "2017-11-06",
        "status": "A",
        "authorized_official_last_name": "MAKRIS",
        "authorized_official_first_name": "VASILIS",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "765-288-1935",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "IN",
            "license": null,
            "primary": false
        },
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200382930A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200316890A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muncie, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2017; 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.