Pacific Retina Inc

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

Legal business name

PACIFIC RETINA INC

Practice address

1109 S Park Victoria Dr
Milpitas, CA 95035-6942

Phone

(714) 732-1417

NPI assigned

Apr 3, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Sanket U Shah, MDNPI 1528355799

Title

Physician

Phone

(714) 732-1417

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

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

• Sanket U Shah, MD

  • Retina Specialist (Ophthalmology) Physician
  • Milpitas, CA
  • NPI 1528355799
  Medicare reassignment NPD Authorized official
• Bonnie Huang Hall, M.D. PH.D

  • Family Medicine Physician
  • Fremont, CA
  • NPI 1417395633
  NPD

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

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729728000000",
    "number": "1043915788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7152 BON VILLA CIR",
            "city": "LA PALMA",
            "state": "CA",
            "postal_code": "906231167",
            "telephone_number": "714-732-1417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 S PARK VICTORIA DR",
            "city": "MILPITAS",
            "state": "CA",
            "postal_code": "950356942",
            "telephone_number": "714-732-1417"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "46923 Warm Springs Blvd Ste 207",
            "address_purpose": "LOCATION",
            "city": "Fremont",
            "state": "CA",
            "postal_code": "945397977",
            "country_code": "US",
            "telephone_number": "669-599-0040",
            "fax_number": "669-201-0557",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PACIFIC RETINA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-03",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "SANKET",
        "authorized_official_middle_name": "U",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "714-732-1417",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology, Retina Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mirna Pacheco-Walker
• Pacific Clinics
• Pacific Clinics
• Pacific Clinics
• Pacific Clinics
• Hermenegildo Gayas Padlan Jr., D.D.S
• Celeste Tripon Pampolina, P.T.
• Puneet Sandhu Pande, DDS
• Nirzari Jayant Pandya, PT
• Grace Pang

• Retina Specialist (Ophthalmology) Physician in Milpitas, CA
• Providers in Milpitas, CA by specialty
• Retina Specialist (Ophthalmology) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2024; 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.