NPIMap

Organization Active NPI

Pacific Cataract and Laser Institute, Inc., P.C.

  • Ambulatory Surgical Clinic/Center
  • Lewiston, ID
National Provider Identifier
1780851691
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
PACIFIC CATARACT AND LASER INSTITUTE, INC., P.C.
Practice address
3330 4TH St
Lewiston, ID 83501-4405
Phone
(208) 746-2025
Fax
(360) 807-7687
NPI assigned
May 9, 2008
Last updated
Jul 18, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Authorized official

Name
Darla Pearson
Title
Credentialing Specialist
Phone
(360) 242-3008

Specialties & licenses 2

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

Addresses

Primary practice location

3330 4TH St
Lewiston, ID 83501-4405

Mailing address

PO Box 1506
Chehalis, WA 98532-0409
Phone (360) 242-3008

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address asc.pclilewiston.p1@direct.pcli.nextgenshare.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050211000861 ID Part B Supplier - Ambulatory Surgical Center 7517864119 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lewiston, ID
O20180818000018 ID Part B Supplier - Ambulatory Surgical Center 7517864119 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Boise, ID

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Pacific Cataract and Laser Institute Inc PCCCN 13C0001043
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
13D1083129Pacific Cataract & Laser Institute3330 4TH St, Lewiston, ID 83501Certificate of waiverApr 27, 2028

National Provider Directory

National Provider Directory
Tax ID family
Pacific Cataract and Laser Institute Inc PC12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3330 4th St
Lewiston, ID 83501
Phone (208) 746-2025

Practitioners & affiliated clinicians

Practitioners 58

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.

View all 58

NPI Registry JSON

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

{
    "created_epoch": "1210291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658102400000",
    "number": "1780851691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1506",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985320409",
            "telephone_number": "360-242-3008",
            "fax_number": "360-807-7687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 4TH ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835014405",
            "telephone_number": "208-746-2025",
            "fax_number": "360-807-7687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC CATARACT AND LASER INSTITUTE, INC., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-09",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A",
        "authorized_official_last_name": "PEARSON",
        "authorized_official_first_name": "DARLA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "360-242-3008"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "ID",
            "license": null,
            "primary": true
        },
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": "ID",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "asc.pclilewiston.p1@direct.pcli.nextgenshare.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "3330 4th St",
            "city": "Lewiston",
            "state": "ID",
            "country_code": "US",
            "postal_code": "835014405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lewiston, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2022; 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.