4th Street Laser & Surgery Center Inc
NPI 1902964174 · Ambulatory Surgical Clinic/Center · Santa Rosa, CA
Enrolled with Medicare as Part B Supplier - Ambulatory Surgical Center · source: CMS PECOS Public Provider Enrollment (2026.04.01)
4th Street Laser & Surgery Center Inc is a Ambulatory Surgical Clinic/Center organization in Santa Rosa, CA (NPI 1902964174).
Provider details
- NPI number
- 1902964174
- Entity type
- Organization
- Primary specialty
- Ambulatory Surgical Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Elayne Clark, Administrator(707) 546-8100
- License
- 110000344 (CA)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
19 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)28% of score
2,495 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Removal of Cataract With Insertion of Prosthetic Lens66984 | 1,250 | $1,597 |
| Phenylephrine 10.16 Mg/Ml and Ketorolac 2.88 Mg/Ml Ophthalmic Irrigation Solution, 1 MlJ1097 | 541 | $96 |
| Removal of Recurring Cataract in Lens Capsule Using a Laser66821 | 500 | $356 |
| Complex Removal of Cataract With Insertion of Prosthetic Lens66982 | 96 | $1,603 |
| Extracapsular Removal of Cataract With Insertion of Artificial Lens and Insertion of Drainage Device in Front Chamber of Eye66991 | 62 | $5,080 |
| Incision to Improve Eye Fluid Flow65820 |
Practice location
Mailing address
Registry dates
- Enumerated
- 2006-12-04
- Last updated
- 2013-01-17
Frequently asked questions
- What is 4th Street Laser & Surgery Center Inc's NPI number?
- 4th Street Laser & Surgery Center Inc's National Provider Identifier (NPI) is 1902964174, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is 4th Street Laser & Surgery Center Inc?
- 4th Street Laser & Surgery Center Inc is classified in the NPPES registry as Ambulatory Surgical Clinic/Center (Ambulatory Health Care Facilities).
- Where is 4th Street Laser & Surgery Center Inc located?
- 4th Street Laser & Surgery Center Inc's practice location on file with NPPES is 1720 4th St, Santa Rosa, CA 95404-3602.
- What is 4th Street Laser & Surgery Center Inc's phone number?
- The practice phone number listed in the NPPES registry for 4th Street Laser & Surgery Center Inc is (707) 546-8100.
- Does 4th Street Laser & Surgery Center Inc accept Medicare?
- 4th Street Laser & Surgery Center Inc is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for 4th Street Laser & Surgery Center Inc?
- The authorized official listed on 4th Street Laser & Surgery Center Inc's NPPES record is Elayne Clark, Administrator. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is 4th Street Laser & Surgery Center Inc's NPI active?
- Yes — 4th Street Laser & Surgery Center Inc's NPI (1902964174) is active in the NPPES registry as of the last update on 2013-01-17.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.