SOUTHERN EYE CENTER OF EXCELLENCE
NPI 1073791158
Clinic/Center - Ophthalmologic Surgery in Hattiesburg, MS
About Southern Eye Center Of Excellence NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTHERN EYE CENTER OF EXCELLENCE (NPI 1073791158) is a healthcare organization registered as an ophthalmologic surgery in Hattiesburg, Mississippi and active in the NPI registry since January 2008. The organization holds 2 active CLIA laboratory certificates and lists Lynn B Mcmahan, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Southern Eye Center Of Excellence is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date 2
Next revalidation due by December 31, 2026
This provider holds 2 Medicare enrollments with upcoming revalidation dates. Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
19Medicare enrollment records show 19 clinicians reassign Medicare billing to Southern Eye Center Of Excellence, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 9 within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 4
Clinicians, nearest first (19)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA 2
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 25D0884478
Southern Eye Surgery Center · Hattiesburg, MSCertificate of Waiver 25D2121649
Southern Eye Surgery And Laser Center LLC · Laurel, MSAreas of Expertise CMS Part B claims 13
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Southern Eye Surgery Center LLC's NPI number?
The NPI number for Southern Eye Surgery Center LLC is 1073791158. It was assigned to this organization in the NPPES registry on January 31, 2008. The provider is doing business as Southern Eye Center Of Excellence.
Where is Southern Eye Surgery Center LLC located?
Southern Eye Surgery Center LLC is located at 1420 S 28th Ave, Hattiesburg, MS 39402. The listed phone number is (601) 264-3937.
What is Southern Eye Surgery Center LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Ophthalmologic Surgery, with taxonomy code 261QS0132X.
Is Southern Eye Surgery Center LLC enrolled in Medicare?
Yes. Southern Eye Surgery Center LLC is registered in the Medicare PECOS enrollment system.
When is Southern Eye Surgery Center LLC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), Southern Eye Surgery Center LLC holds 2 Medicare enrollments with upcoming revalidation dates. The next is due by December 31, 2026 (Non-DME Part B, Mississippi, Clinic/Group Practice). Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Southern Eye Surgery Center LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 19 clinicians in 4 Medicare specialties reassign their Medicare billing to Southern Eye Surgery Center LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Certified Registered Nurse Anesthetist (CRNA) (14), Ophthalmology (3) and Optometry (1). Of these, 3 practice at this address and 9 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Southern Eye Surgery Center LLC hold CLIA laboratory certificates?
Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.
What insurance does Southern Eye Surgery Center LLC accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee and 3 other insurers list Southern Eye Surgery Center LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Southern Eye Surgery Center LLC was last updated on January 15, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Southern Eye Center Of Excellence · NPI 1073791158
Ophthalmologic Surgery organization in Hattiesburg, Mississippi. Organization record, active in the CMS NPPES registry since January 31, 2008.
## Identity
- **NPI:** 1073791158 (Entity type: Organization)
- **Enumerated:** January 31, 2008
- **Primary specialty:** Clinic/Center - Ophthalmologic Surgery · taxonomy 261QS0132X
- **Legal business name:** Southern Eye Surgery Center Llc
- **Organization subpart:** No
- **Authorized official:** Lynn Mcmahan, PRESIDENT
## Practice location
- **Address:** 1420 S 28TH AVE, Hattiesburg, MS 39402-3107
- **Phone:** (601) 264-3937 · **Fax:** (601) 264-5930
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** December 31, 2026 (Non-DME Part B, Mississippi, Clinic/Group Practice), next of 2 enrollments with upcoming dates · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 19 clinicians in 4 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Certified Registered Nurse Anesthetist (CRNA) (14), Ophthalmology (3), Optometry (1); 3 practice at this address and 9 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 15, 2009
- **Other identifiers:** Medicaid 00770066 (MS); Other 512G490003 (MS)
- **CLIA laboratory certificates:** 2 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1073791158) · Data from the CMS NPPES public registry.