Associated Retina Specialist, PLLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

219303-1 Issued in NY

Legal business name

ASSOCIATED RETINA SPECIALIST, PLLC

Practice address

20 W 13TH St
New York, NY 10011-7995

Phone

(212) 604-9800

Fax

(212) 242-4757

NPI assigned

Sep 10, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. John Khadem, MDNPI 1477530012

Title

Owner

Phone

(212) 604-9800

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John J Khadem, M.D., M.P.H.

  • Ophthalmology Physician
  • New York, NY
  • NPI 1477530012
  Medicare reassignment Care Compare group NPD Authorized official
• Cristiana Geny Pieroni, MD

  • Ophthalmology Physician
  • New York, NY
  • NPI 1861525313
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1252540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602028800000",
    "number": "1013240936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 W 13TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100117995",
            "telephone_number": "212-604-9800",
            "fax_number": "212-242-4757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 W 13TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100117995",
            "telephone_number": "212-604-9800",
            "fax_number": "212-242-4757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATED RETINA SPECIALIST, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-10",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A",
        "authorized_official_last_name": "KHADEM",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-604-9800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "219303-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in New York, NY
• Providers in New York, NY by specialty
• Ophthalmology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.