Jedi Ventures, LLC

Primary specialty

Ophthalmologic Surgery Clinic/CenterTaxonomy code 261QS0132X

Legal business name

JEDI VENTURES, LLC

Doing business as

Sacramento Eye SurgiCenter

Practice address

3150 J St
Sacramento, CA 95816-4403

Phone

(916) 444-7052

Fax

(916) 446-1145

NPI assigned

Sep 20, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Keith Liang, M.D.NPI 1043304280

Title

Medical Director

Phone

(916) 444-7052

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Sacramento Eye SurgiCenter Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Ambulatory surgical center certification: CCN 55C0001062

Legal name

SACRAMENTO EYE SURGICENTER

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Mar 24, 1987

Last certification

Apr 19, 2018

Ownership / control type

Proprietary

Facility address

3150 J Street
Sacramento, CA 95816

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 3

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

• Keith Liang, M.D.

  • Ophthalmology Physician
  • Sacramento, CA
  • NPI 1043304280
  NPD (past) Authorized official
• Colin B Arnold, M.D.

  • Ophthalmology Physician
  • Sacramento, CA
  • NPI 1316949779
  NPD (past)
• H Douglas Cooper, M.D.

  • Ophthalmology Physician
  • Sacramento, CA
  • NPI 1518057108
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199836800000",
    "number": "1881792596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3150 J ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958164403",
            "telephone_number": "916-444-7052",
            "fax_number": "916-446-1145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 J ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958164403",
            "telephone_number": "916-444-7052",
            "fax_number": "916-446-1145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEDI VENTURES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2008-01-09",
        "status": "A",
        "authorized_official_last_name": "LIANG",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "916-444-7052",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SUR51062H",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sacramento Eye SurgiCenter",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• April Michelle Jean
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• Christopher Jedel, MD
• Jacquelyn Jee
• Joshua Brevick Jefferds, ND
• Ashley Delane Jeffers
• Jaydon Christian Jefferson-Saenz I
• Cristin Lorrraine Jefferson

• Ophthalmologic Surgery Clinic/Center in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Ophthalmologic Surgery Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2008; 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.
• 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.