Las Vegas East Ophthalmology ASC LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

485ASC-12 Issued in NV

Legal business name

LAS VEGAS EAST OPHTHALMOLOGY ASC LLC

Practice address

3575 Pecos McLeod
Las Vegas, NV 89121-3803

Phone

(702) 731-2088

Fax

(702) 734-7836

NPI assigned

Feb 8, 2006

Organization subpart

No

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

Authorized official

Name

Amy Grim

Title

Credentialing Specialist

Phone

(702) 202-4776

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Shepherd Eye Surgicenter Doing business as

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Listed as

Shepherd Eye SurgicenterCCN 29C0001004

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

Practitioners 1

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

• Steven N Montgomery, M.D.

  • Ophthalmology Physician
  • Las Vegas, NV
  • NPI 1790736031
  NPD (past)

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694044800000",
    "number": "1982677191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 S STEPHANIE ST STE 101",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890125731",
            "telephone_number": "702-202-4776",
            "fax_number": "702-202-6110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3575 PECOS MCLEOD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891213803",
            "telephone_number": "702-731-2088",
            "fax_number": "702-734-7836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAS VEGAS EAST OPHTHALMOLOGY ASC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-08",
        "last_updated": "2023-09-07",
        "certification_date": "2023-03-29",
        "status": "A",
        "authorized_official_last_name": "GRIM",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "702-202-4776"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NV",
            "license": "485ASC-12",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4602450",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shepherd Eye Surgicenter",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Shepherd Eye Surgicenter",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ambulatory Surgical Clinic/Center in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Ambulatory Surgical Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.