Seaside Surgical, LLC

Primary specialty

Ophthalmologic Surgery Clinic/CenterTaxonomy code 261QS0132X

Legal business name

SEASIDE SURGICAL, LLC

Practice address

3303B Glynn Ave
Brunswick, GA 31520-4406

Phone

(912) 466-9500

Fax

(912) 466-9922

NPI assigned

Jan 2, 2009

Last updated

Aug 4, 2025By 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

Lisa J Clark

Title

Office Manager

Phone

(912) 466-9500

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Listed as

Seaside Surgical LLCCCN 11C0001332

Medicare certification status

ActiveFrom the Provider of Services file

Locations

Practitioners 5

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.

• Elizabeth Jane Crandall, MD

  • Ophthalmology Physician
  • Jesup, GA
  • NPI 1023266442
  Medicare reassignment NPD
• Jackie H Johnson Jr., MD

  • Ophthalmology Physician
  • Warner Robins, GA
  • NPI 1679707541
  Medicare reassignment NPD
• Bonnie J Brooks, M.D.

  • Ophthalmology Physician
  • Brunswick, GA
  • NPI 1912973264
  NPD
• David Sassouni Eghigian, O.D.

  • Optometrist
  • Kingsland, GA
  • NPI 1467459057
  NPD
• Angela Royster Scott, MD

  • Ophthalmology Physician
  • Brunswick, GA
  • NPI 1679502934
  NPD (past)

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

{
    "created_epoch": "1230854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754265600000",
    "number": "1780820381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3303B GLYNN AVE",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204406",
            "telephone_number": "912-466-9500",
            "fax_number": "912-466-9922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3303B GLYNN AVE",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204406",
            "telephone_number": "912-466-9500",
            "fax_number": "912-466-9922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEASIDE SURGICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-02",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "912-466-9500"
    },
    "taxonomies": [
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "11C0001332",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "833908673A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Mark Seacat, O.D.
• Eric Devon Seals, LAPC
• Sears Nursing Home, LLC
• Seaside Ophthalmology, Inc
• Seaside Pharmaceutical Inc
• Daniel Edward Seay, MD
• Eric C Segerberg, M.D
• Robert S Seminara Jr., MD
• Marjorie Sen, PHARM.D.
• Serena Skinner Aprn PC

• Ophthalmologic Surgery Clinic/Center in Brunswick, GA
• Providers in Brunswick, GA by specialty
• Ophthalmologic Surgery Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2025; 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.