EASTLAND MEDICAL PLAZA SURGICENTER, LLC
NPI 1699751289
Clinic/Center - Ambulatory Surgical in Bloomington, IL

NPI Status: Active since December 16, 2005

Contact Information

1505 EASTLAND DR
BLOOMINGTON, IL
ZIP 61701
Phone: (309) 663-1997
Fax: (309) 662-9527

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  • Organization
  • Clinic/Center
  • Ambulatory Surgical
  • CLIA Number: 14D0715300
  • CLIA Cert. Type: Ambulatory Surgery Center
  • CLIA Exp. Date: 08-31-2026

About EASTLAND MEDICAL PLAZA SURGICENTER, LLC

This page provides the complete NPI Profile along with additional information for Eastland Medical Plaza Surgicenter, Llc, a provider established in Bloomington, Illinois operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1699751289 assigned on December 2005. The practitioner's primary taxonomy code is 261QA1903X with license number 7002413 (IL). The provider is registered as an organization and their NPI record was last updated 16 years ago. The authorized official of this NPI record is Mrs. Jackie Ann Frye (Business Office Manager)

NPI
1699751289
Provider Name
EASTLAND MEDICAL PLAZA SURGICENTER, LLC
Entity Type
Organization
Location Address
1505 EASTLAND DR BLOOMINGTON, IL 61701
Location Phone
(309) 663-1997
Location Fax
(309) 662-9527
Mailing Address
1505 EASTLAND DR BLOOMINGTON, IL 61701
Mailing Phone
(309) 663-1997
Mailing Fax
(309) 662-9527
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
12-16-2005
Last Update Date
01-06-2010
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Ambulatory Surgical

Taxonomy Code
261QA1903X
Type
Ambulatory Health Care Facilities
License No.
7002413
License State
IL

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MRS. JACKIE ANN FRYE

Authorized Official Title
BUSINESS OFFICE MANAGER
Authorized Official Phone
(309) 663-1997

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
=========001MEDICAID (05)IL 
592800MEDICARE ID-TYPE UNSPECIFIED (04)IL 
7002413OTHER (01)ILSTATE LICENSE

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, less than 3.0 cm

This procedure involves using a flexible tube with a camera, called an endoscope, to gently expand narrowed areas in your esophagus, stomach, or upper small bowel. A small balloon is inflated, making it easier for food and liquid to pass through. It's safe and effective.

This service was performed 21 times for 19 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

This service was performed 179 times for 177 patients

Biopsy of large bowel using a flexible endoscope

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

This service was performed 129 times for 129 patients

Colorectal cancer screening; colonoscopy on individual at high risk

Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.

This service was performed 33 times for 33 patients

Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk

Colorectal cancer screening, such as a colonoscopy, is a preventive measure to detect early signs of cancer in the large intestine. For individuals not at high risk, it's typically recommended at age 50. A small, flexible tube with a camera is used to examine your colon. It's a safe, effective way to catch issues early.

This service was performed 44 times for 44 patients

Complete laser vaporization of prostate including control of bleeding using an endoscope

This procedure involves using a special light instrument to carefully remove tissue from a gland located in the lower body. This helps improve the flow of body fluids. The process is done through a tube-like device and also controls any bleeding.

This service was performed 15 times for 15 patients

Complex removal of cataract with insertion of prosthetic lens

This procedure involves removing a cloudy lens (cataract) from your eye and replacing it with a clear, artificial lens. It helps restore vision that has been affected by the cataract. The operation is usually done under local anesthesia.

This service was performed 17 times for 14 patients

Complicated repair of wound of scalp, arms, or legs, 2.6-7.5 cm

This is a procedure to repair a complex wound on your scalp, arm, or leg that is 2.6-7.5 cm long. It involves cleaning, removing damaged tissue, and stitching the wound to promote healing. It's performed under local or general anesthesia.

This service was performed 14 times for 12 patients

Creation of eye fluid drainage tracts in iris using a laser, per session

This procedure uses a laser to create small drainage tracts in the iris, the colored part of your eye. This helps excess fluid escape, reducing pressure in the eye that can cause glaucoma. It's performed in sessions.

This service was performed 30 times for 21 patients

Crushing of stone of ureter with insertion of stent using an endoscope

This procedure involves using a thin, flexible tube (endoscope) to locate and break down kidney stones in the ureter. After this, a small tube (stent) is inserted to help maintain an open pathway for urine to flow.

This service was performed 18 times for 17 patients

Diagnostic exam of bladder and urethra using an endoscope

This procedure involves using a thin, flexible tube with a light, called an endoscope, to examine the bladder and urethra. It helps in identifying any abnormalities or issues that may be causing discomfort or other symptoms.

This service was performed 12 times for 11 patients

Diagnostic exam of large bowel using a flexible endoscope

This procedure, known as a colonoscopy, involves using a flexible tube with a light and camera to examine the large intestine. It helps detect any abnormalities such as polyps or inflammation. It's a standard procedure to ensure gut health.

This service was performed 49 times for 49 patients

Imaging of urinary tract following injection of a contrast agent

This procedure involves injecting a contrast agent into your body to help highlight the urinary tract during imaging. The contrast agent makes your urinary tract more visible on the images, providing detailed information about its structure and function. This can help in diagnosing any potential issues.

This service was performed 15 times for 14 patients

Injection beneath lining of large bowel using a flexible endoscope

This procedure involves a flexible tube, called an endoscope, being inserted into the large bowel. A small needle is then passed through the tube to inject medication under the bowel lining. This is typically done to treat inflammation or bleeding.

This service was performed 15 times for 14 patients

Insertion of central venous tube with port (5 years or older)

A central venous tube with port is a small, flexible tube inserted into a large vein, usually in the chest. It allows for easy administration of medication, fluids, or blood products over a long period. A port is attached under the skin for easy access. It's safe for individuals aged 5 and above.

This service was performed 15 times for 15 patients

Insertion of stent in ureter using an endoscope

This procedure involves placing a small, flexible tube (stent) in your body's drainage system to help urine flow from the kidneys to the bladder. An endoscope, a thin tube with a light and camera, is used for precise placement.

This service was performed 28 times for 18 patients

Laser repair to improve eye fluid flow

Laser repair to improve eye fluid flow is a procedure aimed at treating glaucoma. A laser is used to create a small hole in the eye's drainage system, allowing fluid to flow out more easily. This helps to lower the pressure inside the eye, reducing the risk of vision loss.

This service was performed 21 times for 12 patients

Processing, preserving and transporting corneal tissue

Processing, preserving, and transporting corneal tissue involve careful steps to ensure its viability for transplantation. The tissue is first cleaned, then preserved in a special solution. It's packed in a temperature-controlled container for safe transport to its destination.

This service was performed 13 times for 13 patients

Removal of cancer skin growth of body, arms, or legs, more than 4.0 cm

This procedure involves surgically removing a cancerous skin growth larger than 4.0 cm on your body, arms, or legs. It's a crucial step in preventing the spread of cancer. Local anesthesia is typically used, and recovery time varies. It's a common and safe procedure.

This service was performed 13 times for 12 patients

Removal of cataract with insertion of prosthetic lens

This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.

This service was performed 822 times for 473 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

This service was performed 200 times for 198 patients

Removal of recurring cataract in lens capsule using a laser

This procedure, known as YAG laser capsulotomy, treats cloudiness in the lens capsule following cataract surgery. A laser is used to create a small hole in the cloudy capsule, allowing light to pass through and restore clear vision. It's a quick, painless procedure.

This service was performed 338 times for 244 patients

Transplantation of outer layer of corneal tissue

The transplantation of the outer layer of corneal tissue is a procedure to replace damaged or diseased corneal tissue with healthy tissue from a donor. This can improve vision and alleviate pain or discomfort.

This service was performed 12 times for 12 patients

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
14D0715300
Facility Type
Ambulatory Surgery Center
Certificate Effective Date
September 01, 2024
Certificate Expiration Date
August 31, 2026
Laboratory Director
MICHELLE L. RIDER
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Eastland Medical Plaza Surgicenter, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1699751289, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 71. The final step is to find the difference between that total and the next multiple of ten (80 - 71 = 9).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
6
Unchanged
Pos 3
9
Doubled → 18 → 1 + 8
Pos 4
9
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
5
Unchanged
Pos 7
1
Doubled → 2
Pos 8
2
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
9
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 9 → 18 → 9 7 → 14 → 5 1 → 2 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 6 + 1 + 8 + 9 + 1 + 4 + 5 + 2 + 2 + 1 + 6 + 24 = 71

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 71 is 80. The difference is the calculated check digit.

80 - 71 = 9
This NPI is valid
The calculated check digit is 9, which matches the last digit of 1699751289.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Ophthalmology
1505 EASTLAND DR, STE 2200
BLOOMINGTON, IL 61701
Ophthalmology
1505 EASTLAND DR, STE 2200
BLOOMINGTON, IL 61701
Ophthalmology
1505 EASTLAND DR, STE 2200
BLOOMINGTON, IL 61701
Obstetrics & Gynecology
1505 EASTLAND DR, SUITE 230
BLOOMINGTON, IL 61701
Plastic Surgery
1505 EASTLAND DR, STE 350
BLOOMINGTON, IL 61701
Nurse Anesthetist, Certified Registered
1505 EASTLAND DR, LL1400
BLOOMINGTON, IL 61701
Anesthesiology (Pain Medicine)
1505 EASTLAND DR, LL 1400
BLOOMINGTON, IL 61701
Anesthesiology (Pain Medicine)
1505 EASTLAND DR, LL 1400
BLOOMINGTON, IL 61701
Nurse Anesthetist, Certified Registered
1505 EASTLAND DR, LL 1400
BLOOMINGTON, IL 61701
Nurse Anesthetist, Certified Registered
1505 EASTLAND DR, LL 1400
BLOOMINGTON, IL 61701
Nurse Anesthetist, Certified Registered
1505 EASTLAND DR, LL1400
BLOOMINGTON, IL 61701
Anesthesiology (Pain Medicine)
1505 EASTLAND DR, LL 1400
BLOOMINGTON, IL 61701
Anesthesiology (Pain Medicine)
1505 EASTLAND DR, LL 1400
BLOOMINGTON, IL 61701
Anesthesiology (Pain Medicine)
1505 EASTLAND DR, LL 1400
BLOOMINGTON, IL 61701
Anesthesiology (Pain Medicine)
1505 EASTLAND DR, LL1400
BLOOMINGTON, IL 61701
Anesthesiology (Pain Medicine)
1505 EASTLAND DR, LL 1400
BLOOMINGTON, IL 61701
Psychologist (Clinical)
1505 EASTLAND DR, EMP II, SUITE LL-1000
BLOOMINGTON, IL 61701
Thoracic Surgery (Cardiothoracic Vascular Surgery)
1505 EASTLAND DR, SUITE 210
BLOOMINGTON, IL 61701
Anesthesiology (Pain Medicine)
1505 EASTLAND DR, SUITE LL 1400
BLOOMINGTON, IL 61701
Ophthalmology
1505 EASTLAND DR, SUITE 2200
BLOOMINGTON, IL 61701

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1699751289, enumerated as an "organization" on December 16, 2005.

The provider is located at 1505 EASTLAND DR BLOOMINGTON, IL 61701 and the phone number is (309) 663-1997.

Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.