NPIMap

Organization Active NPI

Riverside Eye Associates, P.a.

  • Ophthalmology Physician
  • Riverdale, MD
National Provider Identifier
1033154752
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
RIVERSIDE EYE ASSOCIATES, P.A.
Practice address
6510 Kenilworth Ave
Suite 1300
Riverdale, MD 20737-1339
Phone
(301) 699-1882
Fax
(301) 209-9456
NPI assigned
Jun 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Katikineni Mangal, M.D.
Title
President
Phone
(301) 927-2683

Specialties & licenses 1

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

Addresses

Primary practice location

6510 Kenilworth Ave
Suite 1300
Riverdale, MD 20737-1339

Mailing address

6510 Kenilworth Ave
Suite 1300
Riverdale, MD 20737-1339
Phone (301) 699-1882

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1033154752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6510 KENILWORTH AVE",
            "address_2": "SUITE 1300",
            "city": "RIVERDALE",
            "state": "MD",
            "postal_code": "207371339",
            "telephone_number": "301-699-1882",
            "fax_number": "301-209-9456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6510 KENILWORTH AVE",
            "address_2": "SUITE 1300",
            "city": "RIVERDALE",
            "state": "MD",
            "postal_code": "207371339",
            "telephone_number": "301-699-1882",
            "fax_number": "301-209-9456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE EYE ASSOCIATES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MANGAL",
        "authorized_official_first_name": "KATIKINENI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-927-2683",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverdale, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.