NPIMap

Organization Active NPI

Premier Eye Surgery LLC

  • Ambulatory Surgical Clinic/Center
  • Port Orange, FL
National Provider Identifier
1932819836
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
PREMIER EYE SURGERY LLC
Practice address
3641 Clyde Morris Blvd Ste 500
Port Orange, FL 32129-2357
Phone
(386) 788-6198
NPI assigned
Dec 1, 2022
Last updated
Aug 22, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Authorized official

Name
Qing Ge, MDNPI 1225053192
Title
Medical Director
Phone
(386) 788-6198

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

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

Addresses

Primary practice location

3641 Clyde Morris Blvd Ste 500
Port Orange, FL 32129-2357

Mailing address

3641 Clyde Morris Blvd Ste 500
Port Orange, FL 32129-2357
Phone (386) 788-6198

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1669852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692662400000",
    "number": "1932819836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3641 CLYDE MORRIS BLVD STE 500",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321292357",
            "telephone_number": "386-788-6198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3641 CLYDE MORRIS BLVD STE 500",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321292357",
            "telephone_number": "386-788-6198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER EYE SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-01",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A",
        "authorized_official_last_name": "GE",
        "authorized_official_first_name": "QING",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "386-788-6198",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orange, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.