Organization Active NPI

New York Retina Consultants, PLLC

  • Ophthalmology Physician
  • New York, NY
National Provider Identifier
1023567369
Registry record updated Sep 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
176123 Issued in NY
Legal business name
NEW YORK RETINA CONSULTANTS, PLLC
Practice address
310 E 14TH St # 419
New York, NY 10003-4201
Phone
(212) 677-2000
NPI assigned
Sep 28, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2016

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

Authorized official

Name
Peter E Weseley, M.D.
Title
Partner
Phone
(212) 353-5926

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 176123 NY Primary

Addresses

Primary practice location

310 E 14TH St # 419
New York, NY 10003-4201

Mailing address

310 E 14TH St # 419
New York, NY 10003-4201
Phone (212) 677-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171205001519 NY Part B Supplier - Clinic/Group Practice 9133486889 Receives reassigned benefits from 3 practitioners
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Locations

310 E 14th St
Rm 419
New York, NY 10003

Interoperability endpoints

  • Direct secure messaging: jfallon@nyretina.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1475020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475020800000",
    "number": "1023567369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 E 14TH ST # 419",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034201",
            "telephone_number": "212-677-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 E 14TH ST # 419",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034201",
            "telephone_number": "212-677-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW YORK RETINA CONSULTANTS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-28",
        "last_updated": "2016-09-28",
        "status": "A",
        "authorized_official_last_name": "WESELEY",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "212-353-5926",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "176123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2016; 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.