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

Q: What is the provider's specialty?

The provider's specialty is Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.

Active since December 16, 2005CLIA 14D0715300 · Waiver

1505 EASTLAND DR, BLOOMINGTON, IL 61701(309) 663-1997(309) 662-9527 Get Directions Write a Review

NPPES record last updated: January 6, 2010. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Eastland Medical Plaza Surgicenter, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EASTLAND MEDICAL PLAZA SURGICENTER, LLC (NPI 1699751289) is a healthcare organization registered as an ambulatory surgical in Bloomington, Illinois and active in the NPI registry since December 2005. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Jackie Ann Frye, Business Office Manager, as its authorized official.

NPPES Registry Identity

NPI1699751289

Entity TypeOrganization

Primary Taxonomy261QA1903X

Legal Business NameEASTLAND MEDICAL PLAZA SURGICENTER, LLC

Location Address1505 EASTLAND DRBloomington, IL 61701-3534

Mailing Address1505 Eastland DrBloomington, IL 61701-3534 · (309) 663-1997 · Fax (309) 662-9527

Phone(309) 663-1997

Fax(309) 662-9527

Organization SubpartNo

Authorized OfficialJackie Ann FryeBusiness Office Manager · (309) 663-1997

Enumeration DateDecember 16, 2005

Last NPPES UpdateJanuary 6, 2010

✔ NPI 1699751289 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities

Taxonomy Code261QA1903X

License✔ Licensed in IL · 7002413

1505 EASTLAND DR, Bloomington, IL 61701

Open in Google Maps ↗

Other Identifiers 3

Medicaid=========001IL

Medicare ID-Type Unspecified592800IL

Other7002413IL · State License

CLIA Laboratory Certificates CMS CLIA

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 14D0715300

Eastland Medical Plaza Surgicenter LLC · Bloomington, IL

Active · expires Aug 31, 2026

CLIA Number14D0715300

Laboratory TypeAmbulatory Surgery Center

Certificate Effective DateSeptember 1, 2024

Certificate Expiration DateAugust 31, 2026

Laboratory DirectorMichelle L. Rider

Laboratory Phone(217) 855-9608

Laboratory LocationEastland Medical Plaza Surgicenter LLC1505 Eastland Dr Ste 180, Bloomington, IL 61701

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 23

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Removal of cataract with insertion of prosthetic lens 66984

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.

822 services473 patients

Removal of recurring cataract in lens capsule using a laser 66821

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.

338 services244 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

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.

200 services198 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

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.

179 services177 patients

Biopsy of large bowel using a flexible endoscope 45380

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.

129 services129 patients

Diagnostic exam of large bowel using a flexible endoscope 45378

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.

49 services49 patients

Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk G0121

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.

44 services44 patients

Colorectal cancer screening; colonoscopy on individual at high risk G0105

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.

33 services33 patients

Creation of eye fluid drainage tracts in iris using a laser, per session 66761

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.

30 services21 patients

Insertion of stent in ureter using an endoscope 52332

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.

28 services18 patients

Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, less than 3.0 cm 43249

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.

21 services19 patients

Laser repair to improve eye fluid flow 65855

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.

21 services12 patients

Crushing of stone of ureter with insertion of stent using an endoscope 52356

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.

18 services17 patients

Complex removal of cataract with insertion of prosthetic lens 66982

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.

17 services14 patients

Insertion of central venous tube with port (5 years or older) 36561

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.

15 services15 patients

Injection beneath lining of large bowel using a flexible endoscope 45381

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.

15 services14 patients

Complete laser vaporization of prostate including control of bleeding using an endoscope 52648

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.

15 services15 patients

Imaging of urinary tract following injection of a contrast agent 74420

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.

15 services14 patients

Complicated repair of wound of scalp, arms, or legs, 2.6-7.5 cm 13121

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.

14 services12 patients

Removal of cancer skin growth of body, arms, or legs, more than 4.0 cm 11606

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.

13 services12 patients

Processing, preserving and transporting corneal tissue V2785

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.

13 services13 patients

Diagnostic exam of bladder and urethra using an endoscope 52000

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.

12 services11 patients

Transplantation of outer layer of corneal tissue 65756

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.

12 services12 patients

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. EDWARD LESLIE COLLOTON MD

Ophthalmology

1505 EASTLAND DR, STE 2200
BLOOMINGTON, IL 61701

McLean County (309) 662-7700

DR. CATHARINE JEAN CROCKETT MD

Ophthalmology

1505 EASTLAND DR, STE 2200
BLOOMINGTON, IL 61701

McLean County (309) 662-7700

DR. SCOTT MERRILL PINTER MD

Ophthalmology

1505 EASTLAND DR, STE 2200
BLOOMINGTON, IL 61701

McLean County (309) 662-7700

MR. DANIEL ALBERT NORD MD

Obstetrics & Gynecology

1505 EASTLAND DR, SUITE 230
BLOOMINGTON, IL 61701

McLean County (309) 663-8888

DR. JEFFREY SCOTT POULTER M.D.

Plastic Surgery

1505 EASTLAND DR, STE 350
BLOOMINGTON, IL 61701

McLean County (309) 663-1222

NACHELLE RICHARD CRNA

Nurse Anesthetist, Certified Registered

1505 EASTLAND DR, LL1400
BLOOMINGTON, IL 61701

McLean County (309) 663-4700

DR. TIAN BIN FENG MD

Anesthesiology (Pain Medicine)

1505 EASTLAND DR, LL 1400
BLOOMINGTON, IL 61701

McLean County (309) 663-4700

DR. BRUCE CHANDLER MD

Anesthesiology (Pain Medicine)

1505 EASTLAND DR, LL 1400
BLOOMINGTON, IL 61701

McLean County (309) 663-4700

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

About Eastland Medical Plaza Surgicenter, Llc NPPES

NPPES Registry Identity

Specialties & Licenses

Other Identifiers 3

CLIA Laboratory Certificates CMS CLIA

Certificate of Waiver 14D0715300

Areas of Expertise CMS Part B claims 23

Other Providers at the Same Location NPPES 20

Frequently Asked Questions

What is EASTLAND MEDICAL PLAZA SURGICENTER, LLC's NPI number?

Where is the provider located?

What is the provider's specialty?

What insurance does EASTLAND MEDICAL PLAZA SURGICENTER, LLC accept?

About Eastland Medical Plaza Surgicenter, Llc NPPES

NPPES Registry Identity

Specialties & Licenses

Other Identifiers 3

CLIA Laboratory Certificates CMS CLIA

Certificate of Waiver · 14D0715300

Areas of Expertise CMS Part B claims 23

Other Providers at the Same Location NPPES 20

Frequently Asked Questions

What is EASTLAND MEDICAL PLAZA SURGICENTER, LLC's NPI number?

Where is the provider located?

What is the provider's specialty?

What insurance does EASTLAND MEDICAL PLAZA SURGICENTER, LLC accept?

Certificate of Waiver 14D0715300