KINGSTON OPHTHALMOLOGY ASC LLC NPI 1245203405

NPI Information

  • NPI: 1245203405
  • Provider Name: KINGSTON OPHTHALMOLOGY ASC LLC
  • Classification: Clinic/Center - 261QA1903X
  • Specialization: Ambulatory Surgical
  • Entity Type: Organization
  • Doing Business As: KINGSTON SURGERY CENTER
  • Address: 601 WYOMING AVE
    KINGSTON, PA
    ZIP 18704
  • Phone: (570) 288-7405

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NPI Details

KINGSTON OPHTHALMOLOGY ASC LLC is an ambulatory surgical clinic center in Kingston, PA. KINGSTON OPHTHALMOLOGY ASC LLC NPI is 1245203405. The provider is registered as an organization entity type.
The provider Is Doing Business As Kingston Surgery Center.

The provider's business location address is:

601 WYOMING AVE
KINGSTON, PA
ZIP 18704-701
Phone: (570) 288-7405
Fax: (570) 714-0419

The provider's authorized official is Phillip A Clendenin .
The authorized official title is President and has the following contact phone number (615) 665-1283.

The enumeration date for this NPI number is 2/8/2006 and was last updated on 9/7/2023.

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 Surgical94941500PENNSYLVANIAYes

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
1490003620OTHERPENNSYLVANIARAILROAD MEDICARE
2001696312001OTHERPENNSYLVANIAMEDICAL ASSISTANCE
301835908MEDICAIDPENNSYLVANIA
4804568OTHERPENNSYLVANIAFIRST PRIORITY HEALTH
5999035OTHERPENNSYLVANIABLUE CROSS

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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