RIDGE LAKE ASC, LLC
NPI 1790844132
Clinic/Center - Ophthalmologic Surgery in Memphis, TN
NPI Status: Active since December 08, 2006
Contact Information
825 RIDGE LAKE BLVD
MEMPHIS, TN
ZIP 38120
Phone: (901) 685-2200
Fax: (901) 820-2342
- Organization
- Clinic/Center
- Ophthalmologic Surgery
- Accepts Insurance
- CLIA Number: 44D1029640
- CLIA Cert. Type: Ambulatory Surgery Center
- CLIA Exp. Date: 08-19-2026
About RIDGE LAKE ASC, LLC
This page provides the complete NPI Profile along with additional information for Ridge Lake Asc, Llc, a provider established in Memphis, Tennessee operating as a Clinic/center, focusing in ophthalmologic surgery . The healthcare provider is registered in the NPI registry with number 1790844132 assigned on December 2006. The practitioner's primary taxonomy code is 261QS0132X with license number 0000000049 (TN). The provider is registered as an organization and their NPI record was last updated 4 years ago. The authorized official of this NPI record is Subba R Gollamudi Md (Managing Partner)
- NPI
- 1790844132
- Provider Name
- RIDGE LAKE ASC, LLC
- Entity Type
- Organization
- Location Address
- 825 RIDGE LAKE BLVD MEMPHIS, TN 38120
- Location Phone
- (901) 685-2200
- Location Fax
- (901) 820-2342
- Mailing Address
- 825 RIDGE LAKE BLVD MEMPHIS, TN 38120
- Mailing Phone
- (901) 685-2200
- Mailing Fax
- (901) 820-2342
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 12-08-2006
- Last Update Date
- 07-25-2022
- Code Navigator
Location Map
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 Ophthalmologic Surgery
- Taxonomy Code
- 261QS0132X
- Type
- Ambulatory Health Care Facilities
- License No.
- 0000000049
- License State
- TN
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 261QA1903X | Ambulatory Health Care Facilities | Clinic/Center | 0000000049 (TN) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Choice Bronze HSA (QualChoice) - POS
- Complete Gold - PPO
- Complete Gold + Vision + Adult Dental - PPO
- Connected Silver - PPO
- Connected Silver (QualChoice) - POS
- Connected Silver (QualChoice) + Vision + Adult Dental - POS
- Connected Silver (QualChoiceLife) - PPO
- Connected Silver (QualChoiceLife) + Vision + Adult Dental - PPO
- Connected Silver + Vision + Adult Dental - PPO
- Elite Bronze - PPO
- Elite Bronze + Vision + Adult Dental - PPO
- Elite Gold (QualChoice) - POS
- Elite Gold (QualChoice) + Vision + Adult Dental - POS
- Elite Gold (QualChoiceLife) - PPO
- Elite Gold (QualChoiceLife) + Vision + Adult Dental - PPO
- Everyday Bronze - PPO
- Everyday Bronze + Vision + Adult Dental - PPO
- Standard Expanded Bronze - PPO
- Standard Expanded Bronze (QualChoice) - POS
- Standard Expanded Bronze + Vision + Adult Dental - PPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Complete Silver - EPO
- Complete Silver + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Standard Expanded Bronze - EPO
- Standard Expanded Bronze + Vision + Adult Dental - EPO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Standard Silver - EPO
- Standard Silver + Vision + Adult Dental - EPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Standard Expanded Bronze - EPO
- Standard Expanded Bronze + Vision + Adult Dental - EPO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Standard Silver - EPO
- Standard Silver + Vision + Adult Dental - EPO
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Standard Expanded Bronze - EPO
- Standard Expanded Bronze + Vision + Adult Dental - EPO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Standard Silver - EPO
- Standard Silver + Vision + Adult Dental - EPO
- Clear Silver with $0 Insulin Options - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Gold with Atrium Health - HMO
- Complete Gold with Atrium Health + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Bronze with Atrium Health - HMO
- Elite Bronze with Atrium Health + Vision + Adult Dental - HMO
- Enhanced Asthma/COPD Care Silver with $0 Drug Options - HMO
- Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Bronze with Atrium Health - HMO
- Everyday Bronze with Atrium Health + Vision + Adult Dental - HMO
- Focused Silver with Atrium Health - HMO
- Focused Silver with Atrium Health + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Expanded Bronze with Atrium Health - HMO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Standard Expanded Bronze - EPO
- Standard Expanded Bronze + Vision + Adult Dental - EPO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Standard Silver - EPO
- Standard Silver + Vision + Adult Dental - EPO
- Bronze Exp Standardized - PPO
- Bronze Value - PPO
- Catastrophic HSA - PPO
- Gold Standardized - PPO
- Gold Value - PPO
- Silver AH - PPO
- Silver Standardized - PPO
- Dental Gold - PPO
- Dental Gold Plus Vision - PPO
- Dental Pediatric - PPO
- Dental Platinum - PPO
- Dental Platinum Plus Vision - PPO
- Dental Platinum Premium - PPO
- Dental Platinum Premium Plus Vision - PPO
- Dental Silver - PPO
- BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health� - EPO
- BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health� - EPO
- HA Bronze Exp Standardized - POS
- HA Bronze National - POS
- HA Gold Premier National - POS
- HA Gold Standardized - POS
- HA Platinum Premier National - POS
- HA Platinum Standardized - POS
- HA Silver AH - POS
- HA Silver Standardized - POS
- Octave Bronze Exp Standardized - POS
- Octave Bronze Value - POS
- Octave Gold Classic National - POS
- Octave Gold Standardized - POS
- Octave Silver AH - POS
- Octave Silver Standardized - POS
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
- UHC Bronze Copay Focus (Virtual Urgent Care, No Referrals) - EPO
- UHC Bronze Copay Focus + (Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
- UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
- UHC Bronze Essential (No Referrals) - EPO
- UHC Bronze Essential (No Referrals) - HMO
- UHC Bronze Standard (No Referrals) - EPO
- UHC Bronze Standard (No Referrals) - HMO
- UHC Bronze Standard+ (Dental + Vision, No Referrals) - HMO
- UHC Gold Advantage (Virtual Urgent Care, No Referrals) - EPO
- UHC Gold Advantage + (Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - HMO
- UHC Gold Copay Focus (Virtual Urgent Care, No Referrals) - EPO
- UHC Gold Copay Focus + $0 Indiv Med Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
- UHC Gold Standard (No Referrals) - EPO
- UHC Gold Standard (No Referrals) - HMO
- UHC Gold Value ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Gold Value + ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Silver Advantage ($0 Virtual Urgent Care, No Referrals) - HMO
- UHC Silver Advantage (Virtual Urgent Care, No Referrals) - EPO
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.
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 |
|---|---|---|---|
| 190552128 | MEDICAID (05) | AR | |
| 00074013 | MEDICAID (05) | MS | |
| Q016777 | MEDICAID (05) | TN |
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.
Complex extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye
Complex removal of cataract with insertion of prosthetic lens
Dexamethasone, lacrimal ophthalmic insert, 0.1 mg
Dilation to improve eye fluid flow
Exchange of prosthetic lens
Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye
Insertion of eye fluid drainage device
Processing, preserving and transporting corneal tissue
Removal of cataract with insertion of prosthetic lens
Removal of excessive skin and fat of upper eyelid
Removal of recurring cataract in lens capsule using a laser
Repair of detached retina with drainage and removal of eye fluid between lens and retina
Transplantation of outer layer of corneal tissue
This procedure involves removing a cloudy lens (cataract) from your eye through a larger incision, replacing it with an artificial one. A drainage device is also inserted in the front part of your eye to manage fluid levels, helping maintain eye health.
This service was performed 23 times for 19 patientsThis 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 179 times for 158 patientsDexamethasone, lacrimal ophthalmic insert, 0.1 mg is a tiny device inserted into your tear duct. It releases a steroid, dexamethasone, to reduce inflammation and discomfort in your eye. It's often used for conditions like dry eye or following eye surgery.
This service was performed 3,453 times for 595 patientsDilation to improve eye fluid flow is a process where eye drops are used to widen or dilate your pupils. This allows more fluid to flow out of the eye, reducing pressure and helping to prevent or treat conditions like glaucoma.
This service was performed 116 times for 82 patientsAn exchange of a prosthetic lens involves replacing an artificial lens in your eye. This is often done if the current lens isn't functioning properly or causing discomfort. The procedure involves removing the old lens and inserting a new one, aiming to improve your vision.
This service was performed 13 times for 13 patientsThis 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.
This service was performed 102 times for 72 patientsThe insertion of an eye fluid drainage device is a procedure to manage eye pressure. A small device is placed in the eye to help drain excess fluid, reducing pressure that can damage the optic nerve and lead to vision loss. This procedure is often used for glaucoma treatment.
This service was performed 93 times for 71 patientsProcessing, 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 18 times for 16 patientsThis 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 1,840 times for 1,219 patientsThis procedure, also known as upper eyelid surgery, is performed to remove excess skin and fat from the upper eyelid. It can help improve vision if heavy eyelids hinder it, and can also enhance the appearance of the eyes. It's a common, safe procedure.
This service was performed 22 times for 11 patientsThis 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 647 times for 444 patientsThis procedure addresses a detached retina, a serious eye condition. It involves draining fluid from between the lens and retina, allowing the retina to reattach. Then, the eye fluid is removed to prevent future detachments. It's a crucial step for vision restoration.
This service was performed 13 times for 11 patientsThe 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 11 patientsCLIA 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
- 44D1029640
- Facility Type
- Ambulatory Surgery Center
- Certificate Effective Date
- August 20, 2024
- Certificate Expiration Date
- August 19, 2026
- Laboratory Director
- ANDREW CROTHERS
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Ridge Lake Asc, 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 1790844132, we treat the final digit (2) 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 68. The final step is to find the difference between that total and the next multiple of ten (70 - 68 = 2).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 68 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1790844132, enumerated as an "organization" on December 08, 2006.
The provider is located at 825 RIDGE LAKE BLVD MEMPHIS, TN 38120 and the phone number is (901) 685-2200.
Clinic/Center with taxonomy code 261QS0132X and a focus in Ophthalmologic Surgery.
The provider might be accepting Accepts: Ambetter from Arkansas Health & Wellness, Ambetter. Please consult your insurance carrier or call the provider to verify.
