East Atlanta Eye Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

EAST ATLANTA EYE SURGERY CENTER, LLC

Practice address

550 Professional Dr
Lawrenceville, GA 30046-7686

Phone

(470) 410-8120

NPI assigned

Mar 23, 2020

Organization subpart

No

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

Authorized official

Name

Mrs. Margaret Welborn, RN

Title

Nurse Manager

Phone

(470) 410-8120

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Listed as

East Atlanta Eye Surgery CenterCCN 11C0001529

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

Locations

Practitioners 1

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

• Eugene B. Gabianelli, M.D.

  • Ophthalmology Physician
  • Atlanta, GA
  • NPI 1104838697
  NPD

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

{
    "created_epoch": "1584921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617667200000",
    "number": "1861029712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 PROFESSIONAL DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300467686",
            "telephone_number": "470-410-8120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 PROFESSIONAL DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300467686",
            "telephone_number": "470-410-8120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST ATLANTA EYE SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-23",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A",
        "authorized_official_last_name": "WELBORN",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_title_or_position": "NURSE MANAGER",
        "authorized_official_telephone_number": "470-410-8120",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA STATE FACILITY LICENSE",
            "identifier": "067-377",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Sarah Grace Eason, DPT
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• Ambulatory Surgical Clinic/Center in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Ambulatory Surgical Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2021; 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.