East Texas Eye Associates

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

210 Issued in TX

Legal business name

EAST TEXAS EYE ASSOCIATES

Doing business as

East Texas Eye Associates Surgery Center

Practice address

1306 W Frank Ave
Lufkin, TX 75904-3313

Phone

(936) 634-8381

Fax

(936) 639-9848

NPI assigned

Feb 1, 2006

Last updated

Mar 27, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Jo Ann O'Neill, C.O.T.

Title

Administrator

Phone

(936) 634-8381

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• East Texas Eye Associates Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1770554297. Details of each certification follow.

• CCN 45C0001577 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 45C0001577

Legal name

EAST TEXAS EYE ASSOCIATES SURGERY CENTER

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Jun 11, 2015

Last certification

Mar 29, 2017

Ownership / control type

Proprietary

Facility address

1306 W Frank Avenue
Lufkin, TX 75904

Other NPIs with the same Medicare PAC ID 1

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

• East Texas Eye Associates

  • Specialist
  • Lufkin, TX
  • NPI 1508806894

  1254335607

  Same PAC ID

Practitioners 2

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.

• Thomas Everett Duncan, M.D.

  • Ophthalmology Physician
  • Lufkin, TX
  • NPI 1063484137
  Medicare reassignment
• Jacob Sapp, CRNA

  • Certified Registered Nurse Anesthetist
  • Lufkin, TX
  • NPI 1376872317
  NPD

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427414400000",
    "number": "1770554297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 W FRANK AVE",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759043313",
            "telephone_number": "936-634-8381",
            "fax_number": "936-639-9848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1306 W FRANK AVE",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759043313",
            "telephone_number": "936-634-8381",
            "fax_number": "936-639-9848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TEXAS EYE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-01",
        "last_updated": "2015-03-27",
        "status": "A",
        "authorized_official_last_name": "O'NEILL",
        "authorized_official_first_name": "JO",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "936-634-8381",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "C.O.T."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TX",
            "license": "210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127345005",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "490001072",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "HH1305",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Texas Eye Associates Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ease Prosthetics
• Kaela Easley, LPC-A
• East Texas Cancer Alliance of Hope
• East Texas Chest Clinic, P.a.
• East Texas Eye Associates
• East Texas Eye Associates (East Texas Eye Associates Optical Shop)
• East Texas Foot Associates
• East Texas Heart & Vascular Imaging LTD
• East Texas Heart & Vascular Imaging of Lufkin, PA
• East Texas Hematology & Oncology

• Ambulatory Surgical Clinic/Center in Lufkin, TX
• Providers in Lufkin, TX by specialty
• Ambulatory Surgical Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.