NPIMap

Organization Active NPI

Florence Surgery & Laser Center LLC

  • Ophthalmologic Surgery Clinic/Center
  • Florence, SC
National Provider Identifier
1912959560
Registry record updated Aug 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmologic Surgery Clinic/CenterTaxonomy code 261QS0132X
License
802523 Issued in SC
Legal business name
FLORENCE SURGERY & LASER CENTER LLC
Practice address
400 N Cashua Dr
Florence, SC 29501
Phone
(843) 664-2460
Fax
(843) 664-2460
NPI assigned
May 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2018

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

Authorized official

Name
Dr. Samuel Eric Seltzer, MD
Title
Owner
Phone
(843) 664-9393

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmologic Surgery Clinic/Center 261QS0132X 802523 SC Primary

Addresses

Primary practice location

400 N Cashua Dr
Florence, SC 29501

Mailing address

400 N Cashua Dr
Florence, SC 29501-2098
Phone (843) 664-2460

Other identifiers 2

IdentifierTypeStateIssuer
3409931MedicaidNC
GP3952MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040416000093 SC Part B Supplier - Clinic/Group Practice 0042102428 Receives reassigned benefits from 12 practitioners
Practice locations: Florence, SC

National Provider Directory

National Provider Directory

Locations

400 N Cashua Dr
Florence, SC 29501
Phone (843) 664-9398

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534982400000",
    "number": "1912959560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N CASHUA DR",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295012098",
            "telephone_number": "843-664-2460",
            "fax_number": "843-664-2460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N CASHUA DR",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "29501",
            "telephone_number": "843-664-2460",
            "fax_number": "843-664-2460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORENCE SURGERY & LASER CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2018-08-23",
        "status": "A",
        "authorized_official_last_name": "SELTZER",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-664-9393",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": "SC",
            "license": "802523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3409931",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3952",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.