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

Q: What is Eastland Medical Plaza Surgicenter, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

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: August 09, 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 19

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.

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.

831 services473 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.

216 services216 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.

187 services178 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.

151 services151 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.

82 services60 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.

55 services55 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.

46 services29 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.

44 services39 patients

Correction of toe joint deformity 28285

Correction of toe joint deformity is a procedure to fix misshapen toe joints. This can involve realigning the bones, removing bone or tissue, or implanting devices to improve joint function. It can help reduce pain and improve mobility.

40 services21 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.

39 services39 patients

Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye 66991

This is a two-part eye procedure. First, a cloudy lens (cataract) is removed from its outer layer and replaced with an artificial lens to improve vision. Second, a drainage device is inserted into the front part of the eye to manage fluid levels, preventing pressure build-up.

24 services14 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 services18 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.

20 services20 patients

Removal of polyps or growths of esophagus, stomach, and/or upper small bowel using an endoscope with mechanical snare 43251

This procedure involves the use of a thin, flexible instrument called an endoscope to visualize and remove abnormal growths, known as polyps, from the esophagus, stomach, or upper small bowel. A tool called a mechanical snare is used to safely cut and remove these growths.

17 services17 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.

15 services13 patients

Destruction of growth of bladder and urethra using an endoscope, less than 0.5 cm 52224

This procedure involves using a special instrument called an endoscope to remove a small growth in your bladder and urethra. It's a minimally invasive procedure and the growth being treated is less than half a centimeter in size.

14 services13 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.

14 services14 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 services12 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

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. VENKATA RANGANADH DODDA MD

Internal Medicine (Critical Care Medicine)

1505 EASTLAND DR, SUITE 320
BLOOMINGTON, IL 61701

McLean County (309) 661-2368

DR. EDWARD LESLIE COLLOTON MD

Ophthalmology

1505 EASTLAND DR, STE 2200
BLOOMINGTON, IL 61701

McLean County (309) 662-7700

MS. MELANIE SCHALL

Pharmacist

1505 EASTLAND DR
BLOOMINGTON, IL 61701

McLean County (309) 664-0505

NORD OBSTETRICS AND GYNECOLOGY, SC

Obstetrics & Gynecology

1505 EASTLAND DR, #230
BLOOMINGTON, IL 61701

McLean County (309) 663-8888

KENNETH H. INOUE

Internal Medicine

1505 EASTLAND DR
BLOOMINGTON, IL 61701

McLean County (309) 661-2368

MCLEAN COUNTY ANESTHESIOLOGY, LTD.

Anesthesiology (Pain Medicine)

1505 EASTLAND DR, SUITE LL 1400
BLOOMINGTON, IL 61701

McLean County (309) 663-4700

CAROLINE J TURNER APN

Nurse Practitioner

1505 EASTLAND DR
BLOOMINGTON, IL 61701

McLean County (309) 665-4040

DANIELLE BEER

Physician Assistant

1505 EASTLAND DR
BLOOMINGTON, IL 61701

McLean County (309) 663-2100

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 Eastland Medical Plaza Surgicenter, LLC's NPI number?

The NPI number for Eastland Medical Plaza Surgicenter, LLC is 1699751289. It was assigned to this organization in the NPPES registry on December 16, 2005.

Where is Eastland Medical Plaza Surgicenter, LLC located?

Eastland Medical Plaza Surgicenter, LLC is located at 1505 Eastland Dr, Bloomington, IL 61701. The listed phone number is (309) 663-1997.

What is Eastland Medical Plaza Surgicenter, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Does Eastland Medical Plaza Surgicenter, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D0715300) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Eastland Medical Plaza Surgicenter, LLC was last updated on January 6, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.

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 19

Other Providers at the Same Location NPPES 20

Frequently Asked Questions NPPES & CMS

What is Eastland Medical Plaza Surgicenter, LLC's NPI number?

Where is Eastland Medical Plaza Surgicenter, LLC located?

What is Eastland Medical Plaza Surgicenter, LLC's specialty?

Does Eastland Medical Plaza Surgicenter, LLC hold a CLIA laboratory certificate?

When was this NPI record last updated?

Certificate of Waiver 14D0715300