Vermont Eye Surgery & Laser Center

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

VERMONT EYE SURGERY & LASER CENTER

Practice address

1100 Hinesburg Rd
Suite 101
South Burlington, VT 05403-7613

Phone

(802) 862-1808

Fax

(802) 862-6664

NPI assigned

Feb 28, 2008

Organization subpart

No

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

Authorized official

Name

Freda Ciosek

Title

Contact Person

Phone

(802) 862-1808

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in VT

Enrollment records 1

Listed as

Vermont Eye Surgery Laser Center LLCCCN 47C0001000

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.

• Juli A Larson, MD

  • Ophthalmology Physician
  • South Burlington, VT
  • NPI 1396796710
  NPD
• Praveen H. Keshava, M.D.

  • Ophthalmology Physician
  • Rutland, VT
  • NPI 1336165596
  NPD (past)
• Katherine A Lane, MD

  • Ophthalmology Physician
  • South Burlington, VT
  • NPI 1417179029
  NPD (past)
• Gregory McCormick, M.D.

  • Ophthalmology Physician
  • South Burlington, VT
  • NPI 1508817446
  NPD (past)
• David A Shiple, M.D.

  • Ophthalmology Physician
  • Rochester, NY
  • NPI 1780828533
  NPD (past)

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

{
    "created_epoch": "1204156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265241600000",
    "number": "1831368356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 HINESBURG RD",
            "address_2": "SUITE 101",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054037613",
            "telephone_number": "802-862-1808",
            "fax_number": "802-862-6664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 HINESBURG RD",
            "address_2": "SUITE 101",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054037613",
            "telephone_number": "802-862-1808",
            "fax_number": "802-862-6664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERMONT EYE SURGERY & LASER CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-28",
        "last_updated": "2010-02-04",
        "status": "A",
        "authorized_official_last_name": "CIOSEK",
        "authorized_official_first_name": "FREDA",
        "authorized_official_title_or_position": "CONTACT PERSON",
        "authorized_official_telephone_number": "802-862-1808"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "VT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1015944",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00717828",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vermont Catholic Charities, Inc
• Vermont Center for Integrative Therapy, LLC
• Vermont CVS Pharmacy LLC
• Vermont Dental Medicine PLLC
• Vermont Doula Company
• Vermont Family Dental PLC
• Vermont Gynecology, PC
• Vermont Mindfulness and Psychotherapy L.L.C.
• Vermont Open MRI
• Vermont Pain Management PC

• Ambulatory Surgical Clinic/Center in South Burlington, VT
• Providers in South Burlington, VT by specialty
• Ambulatory Surgical Clinic/Center in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2010; 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.