Laser & Surgical Eye Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

LASER & SURGICAL EYE CENTER LLC

Practice address

1333 E Barnett Rd
Medford, OR 97504-8219

Phone

(541) 779-4711

Fax

(541) 618-1485

NPI assigned

Dec 1, 2006

Organization subpart

No

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

Authorized official

Name

Keith Casebolt

Title

Ceo

Phone

(541) 779-4711

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Listed as

Laser and Surgical Eye Center LLCCCN 38C0001022

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

Practitioners 8

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

• Helen Koenigsman, M.D.

  • Glaucoma Specialist (Ophthalmology) Physician
  • Medford, OR
  • NPI 1013179274
  Medicare reassignment NPD
• Craig Augustus Lemley, MD

  • Retina Specialist (Ophthalmology) Physician
  • Medford, OR
  • NPI 1285685032
  Medicare reassignment NPD
• Poorav Jitendra Patel, MD, MHS

  • Ophthalmology Physician
  • Medford, OR
  • NPI 1689014409
  NPD
• Elizabeth Lacey Echalier, M.D.

  • Ophthalmic Plastic and Reconstructive Surgery Physician
  • Medford, OR
  • NPI 1811316144
  NPD (past)
• Matthew S Oliva, MD

  • Cornea and External Diseases Specialist Physician
  • Medford, OR
  • NPI 1750450573
  NPD (past)
• Christine Ann Petersen, M.D.

  • Glaucoma Specialist (Ophthalmology) Physician
  • Medford, OR
  • NPI 1639580194
  NPD (past)
• Steven Sepehr Saraf, MD

  • Retina Specialist (Ophthalmology) Physician
  • Medford, OR
  • NPI 1649545112
  NPD (past)
• John Welling, MD

  • Cornea and External Diseases Specialist Physician
  • Medford, OR
  • NPI 1306159173
  NPD (past)

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256515200000",
    "number": "1720156482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 E BARNETT RD",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048219",
            "telephone_number": "541-779-4711",
            "fax_number": "541-618-1485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 E BARNETT RD",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048219",
            "telephone_number": "541-779-4711",
            "fax_number": "541-618-1485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LASER & SURGICAL EYE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2009-10-26",
        "status": "A",
        "authorized_official_last_name": "CASEBOLT",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "541-779-4711"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136452",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "490003025",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shannon Larsen
• Shannon Jean Larsen, CADC II
• Jennifer Lynn Larson, LMT
• Kimberly D. Larson, WHCNP
• Tanya Eileen Larson, L.M.T., NCTMB
• Lassman'S Fine Eyewear,Inc.
• Summaya Abdul Latif, M.D.
• Jeffrie Lattman, RPH
• Grace Laughery
• Emma Rose Launder

• 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 Oct 26, 2009; 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.