Retina Center of Western Maryland

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

D0052418 Issued in MD

Legal business name

RETINA CENTER OF WESTERN MARYLAND

Practice address

251 E Baltimore St
Lower Level
Hagerstown, MD 21740-6144

Phone

(301) 416-8600

Fax

(301) 416-8602

NPI assigned

Dec 28, 2005

Organization subpart

No

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

Authorized official

Name

Dara Tash, MDNPI 1033118419

Title

Ceo

Phone

(301) 416-8600

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Locations

Practitioners 3

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

• Dara Tash, M.D.

  • Specialist
  • Hagerstown, MD
  • NPI 1033118419
  Medicare reassignment NPD Authorized official
• Brian C Lerner, M.D.

  • Addiction Psychiatry Physician
  • Havre de Grace, MD
  • NPI 1629044078

  Ophthalmology

  NPD (past)
• Renee A Lerner, M.D.

  • Ophthalmology Physician
  • Baltimore, MD
  • NPI 1417923640
  NPD (past)

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266537600000",
    "number": "1043297385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 E BALTIMORE ST",
            "address_2": "LOWER LEVEL",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217406144",
            "telephone_number": "301-416-8600",
            "fax_number": "301-416-8602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 E BALTIMORE ST",
            "address_2": "LOWER LEVEL",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217406144",
            "telephone_number": "301-416-8600",
            "fax_number": "301-416-8602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RETINA CENTER OF WESTERN MARYLAND",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-28",
        "last_updated": "2010-02-19",
        "status": "A",
        "authorized_official_last_name": "TASH",
        "authorized_official_first_name": "DARA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "301-416-8600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "MD",
            "license": "D0052418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170200900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erica Repac
• Nicole N Repp
• Resolution Advocates, LLC
• Resolution Advocates, LLC
• Resonant Counseling LLC
• Darlynnes Reyes Alonzo
• Jorge Reyes
• Christina Elizabeth Reynolds, SPEECH THERAPIST
• Curtis Lee Reynolds III, M.D.
• Danielle Lashawne Reynolds, M.D.

• Ophthalmology Physician in Hagerstown, MD
• Providers in Hagerstown, MD by specialty
• Ophthalmology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2010; 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.