AUGUSTA RETINA LASER SURGICARE NPI 1235118043

NPI Information

  • NPI: 1235118043
  • Provider Name: AUGUSTA RETINA LASER SURGICARE
  • Classification: Clinic/Center - 261QA1903X
  • Specialization: Ambulatory Surgical
  • Entity Type: Organization
  • CLIA Number: 11D0960343
  • Address: 3685 WHEELER RD
    SUITE 202
    AUGUSTA, GA
    ZIP 30909
  • Phone: (706) 210-0305

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NPI Details

AUGUSTA RETINA LASER SURGICARE is an ambulatory surgical clinic center in Augusta, GA. AUGUSTA RETINA LASER SURGICARE NPI is 1235118043. The provider is registered as an organization entity type.

The provider's business location address is:

3685 WHEELER RD
SUITE 202
AUGUSTA, GA
ZIP 30909-446
Phone: (706) 210-0305
Fax: (706) 210-0306

The provider's authorized official is Kevin Becker .
The authorized official title is Cfo and has the following contact phone number (706) 243-2259.

The CLIA number assigned to this NPI record is 11D0960343 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Destruction of leaking blood vessels of retina using laser (HCPCS:67228)
  • Removal of membrane of retina with removal of internal limiting membrane of retina (HCPCS:67042)
  • Photocoagulation treatment to prevent detachment of retina (HCPCS:67145)

The enumeration date for this NPI number is 1/10/2006 and was last updated on 2/6/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QA1903XClinic/CenterAmbulatory SurgicalGEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1ASC025MEDICAIDSOUTH CAROLINA
2000874794AMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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