Organization Active NPI

Retina Care Group, Inc

  • Ophthalmology Physician
  • Farrell, PA
National Provider Identifier
1053039636
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
RETINA CARE GROUP, INC
Practice address
350 Sharon New Castle Rd
Farrell, PA 16121-1576
Phone
(724) 248-2020
NPI assigned
Aug 18, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Authorized official

Name
Marc Estafanous, MD
Title
MD
Phone
(724) 248-2020

Specialties & licenses 1

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

Addresses

Primary practice location

350 Sharon New Castle Rd
Farrell, PA 16121-1576

Mailing address

350 Sharon New Castle Rd
Farrell, PA 16121-1576
Phone (724) 248-2020

Other practice location 1

24 Doctors Ln Ste 101
Clarion, PA 16214-8568
Phone (724) 248-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20221025001000 PA Part B Supplier - Clinic/Group Practice 4789050238 Receives reassigned benefits from 5 practitioners
Practice locations: Clarion, PA; Erie, PA; Farrell, PA; Meadville, PA; New Castle, PA
O20230524002576 OH Part B Supplier - Clinic/Group Practice 4789050238 Receives reassigned benefits from 1 practitioner
Practice locations: Canton, OH

National Provider Directory

National Provider Directory

Locations

390 Linden St
Lowr
Meadville, PA 16335
Phone (724) 248-2020

390 Linden St
Meadville, PA 16335
Phone (412) 466-8011

177 Enclave Dr
New Castle, PA 16105
Phone (724) 658-5523

Interoperability endpoints

  • Direct secure messaging: mestafanous@estafanous.intellechartdirect.net
  • Direct secure messaging: amehra@estafanous.intellechartdirect.net
  • Direct secure messaging: shuang@estafanous.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 5

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": "1660780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711497600000",
    "number": "1053039636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 SHARON NEW CASTLE RD",
            "city": "FARRELL",
            "state": "PA",
            "postal_code": "161211576",
            "telephone_number": "724-248-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 SHARON NEW CASTLE RD",
            "city": "FARRELL",
            "state": "PA",
            "postal_code": "161211576",
            "telephone_number": "724-248-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24 Doctors Ln Ste 101",
            "address_purpose": "LOCATION",
            "city": "Clarion",
            "state": "PA",
            "postal_code": "162148568",
            "country_code": "US",
            "telephone_number": "724-248-2020",
            "fax_number": "724-936-2021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RETINA CARE GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-18",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A",
        "authorized_official_last_name": "ESTAFANOUS",
        "authorized_official_first_name": "MARC",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "724-248-2020",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farrell, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.