The Laser & Surgery Center is a medicare enrolled "Ophthalmology" provider in Clarkston, Washington. Their current practice location is
500 Port Dr, Clarkston, Washington. You can reach out to their office (for appointments etc.) via phone at
(509) 758-8811.
The Laser & Surgery Center is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. The Laser & Surgery Center
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1639160450.
Healthcare Provider's Profile
| Full Name | The Laser & Surgery Center |
|---|
| Type | Facility |
|---|
| Speciality | Ophthalmology |
|---|
| Location | 500 Port Dr, Clarkston, Washington |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1639160450
- Provider Enumeration Date: 11/01/2005
- Last Update Date: 04/30/2008
Medicare PECOS Information:
- PECOS PAC ID: 3779473723
- Enrollment ID: O20040317000302
Medical Identifiers
Medical identifiers for The Laser & Surgery Center such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1639160450 | NPI | - | NPPES |
| 0123143 | Other | WA | LABOR & INDUSTRY |
| 7088859 | Medicaid | WA | |
| 8927759 | Other | WA | CRIME VICTIMS COMPENSATION ACT |
| BYHB9 | Other | ID | BLUE CROSS OF IDAHO |
| 000010006385 | Other | ID | REGENCE BLUE SHIELD OF IDAHO |
| 805350600 | Medicaid | ID | |
| 85977 | Other | ID | BLUE CROSS OF IDAHO |
| QMXPR0064816 | Other | WA | MOLINA HEALTHCARE |
| 000010006387 | Other | | FEDERAL BLUE CROSS |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 152W00000X | Optometrist | (* (Not Available)) | Secondary |
| 207W00000X | Ophthalmology | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
The Laser & Surgery Center acts as a billing entity for following providers:
| Provider Name | Chad R Bouterse |
|---|
| Provider Type | Practitioner - Ophthalmology |
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| Provider Identifiers | NPI Number: 1699896167
PECOS PAC ID: 0648321224
Enrollment ID: I20100225000087 |
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| Provider Name | Mark T Eggleston |
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| Provider Type | Practitioner - Ophthalmology |
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| Provider Identifiers | NPI Number: 1306836705
PECOS PAC ID: 7416958293
Enrollment ID: I20100423000930 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. The Laser & Surgery Center is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
The Laser & Surgery Center
500 Port Dr,
Clarkston, WA 99403-1835
Ph: (509) 758-8811 | The Laser & Surgery Center
500 Port Dr,
Clarkston, WA 99403-1835
Ph: (509) 758-8811 |
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