NPIMap

Organization Active NPI

Canton Eye Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Canton, GA
National Provider Identifier
1992122329
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
CANTON EYE SURGERY CENTER
Practice address
201 Kimberly Way Ste 104
Canton, GA 30114-8009
Phone
(678) 381-2020
Fax
(678) 381-2015
NPI assigned
Mar 24, 2014
Last updated
Apr 5, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

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

Authorized official

Name
Milan R Patel, M.D.NPI 1396789079
Title
President
Phone
(678) 381-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

201 Kimberly Way Ste 104
Canton, GA 30114-8009

Mailing address

1034 Haw Creek Cir Ste 100
Cumming, GA 30041-6513
Phone (678) 381-2020

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141113000339 GA Part B Supplier - Ambulatory Surgical Center 1254553936 Receives reassigned benefits from 21 practitioners
Practice locations: Canton, GA

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Canton Eye Surgery CenterCCN 11C0001433
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2080146Canton Eye Surgery Center201 Kimberly Way, Suite 104, Canton, GA 30114Certificate of waiverJun 30, 2028

National Provider Directory

National Provider Directory

Locations

201 Kimberly Way
Canton, GA 30114

Practitioners & affiliated clinicians

Practitioners 28

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.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1395619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680652800000",
    "number": "1992122329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 HAW CREEK CIR STE 100",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300416513",
            "telephone_number": "678-381-2020",
            "fax_number": "678-381-2015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 KIMBERLY WAY STE 104",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301148009",
            "telephone_number": "678-381-2020",
            "fax_number": "678-381-2015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANTON EYE SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-24",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "MILAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "678-381-2020",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 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.