West Suburban Eye Surgery Center LLC

Primary specialty

Ophthalmologic Surgery Clinic/CenterTaxonomy code 261QS0132X

Legal business name

WEST SUBURBAN EYE SURGERY CENTER LLC

Practice address

1440 Main St
Waltham, MA 02451-1623

Phone

(781) 891-9300

Fax

(781) 891-9305

NPI assigned

May 20, 2006

Organization subpart

No

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

Authorized official

Name

Andrew J Gillies, M.D.

Title

Medical Director

Phone

(781) 891-9300

Specialties & licenses 1

Addresses

Other names 1

• Surgisite Boston Doing business as

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• West Suburban Eye Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Chelmsford, MA
  • NPI 1194275230

  7113939687

  Same PAC ID

Listed as

Surgisite BostonCCN 22C0001055

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

Tax ID family

Surgisite Boston2 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.

• West Suburban Eye Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Chelmsford, MA
  • NPI 1194275230
  NPD tax ID

Member of 1

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

• Pratt Ophthalmology Associates, Inc

  • Optician
  • Brighton, MA
  • NPI 1063531648

  Member Of

  NPD member

Locations

Practitioners 1

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

• Evan Bruce Gold, M.D.

  • Ophthalmology Physician
  • Needham, MA
  • NPI 1760441034
  NPD

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370304000000",
    "number": "1770537227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 MAIN ST",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024511623",
            "telephone_number": "781-891-9300",
            "fax_number": "781-891-9305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 MAIN ST",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024511623",
            "telephone_number": "781-891-9300",
            "fax_number": "781-891-9305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST SUBURBAN EYE SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2013-06-04",
        "status": "A",
        "authorized_official_last_name": "GILLIES",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEDICAL  DIRECTOR",
        "authorized_official_telephone_number": "781-891-9300",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Surgisite Boston",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Aneesa Wermers, LCSW
• Michelle Christine Wertz
• Janice Marie Wesley, PT
• Christian Joseph Wesolowski
• Jenna Lee Wessels
• Marcy Wynne West, LICSW
• Erika Stewart Wheelhouse, M.A., LMHC
• Allison Suzanne White, LICSW
• Laura White, NP
• Paul White

• Ophthalmologic Surgery Clinic/Center in Waltham, MA
• Providers in Waltham, MA by specialty
• Ophthalmologic Surgery Clinic/Center in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2013; 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.