Central New York Retinal Associates PC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

CENTRAL NEW YORK RETINAL ASSOCIATES PC

Practice address

1101 Erie Blvd E
Suite 210
Syracuse, NY 13210-1148

Phone

(315) 952-6760

NPI assigned

Aug 18, 2014

Organization subpart

No

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

Authorized official

Name

Charles MangoNPI 1285637611

Title

MD

Phone

(315) 952-6760

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 1

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

• Charles Mango, MD

  • Ophthalmology Physician
  • Syracuse, NY
  • NPI 1285637611
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1408320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408320000000",
    "number": "1083013965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 ERIE BLVD E",
            "address_2": "SUITE 210",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 ERIE BLVD E",
            "address_2": "SUITE 210",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101148",
            "telephone_number": "315-952-6760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL NEW YORK RETINAL ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-18",
        "last_updated": "2014-08-18",
        "status": "A",
        "authorized_official_last_name": "MANGO",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "315-952-6760"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Central New York DC, LLC
• Central New York Infusion Services, LLC
• Central New York Medical Practice, PLLC
• Central New York Medical Products, Inc.
• Central New York Research Corperation
• Central New York Services
• Central New York Services
• Central New York Services
• Central New York Services, Inc
• Central New York Services, Inc.

• Ophthalmology Physician in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Ophthalmology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2014; 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.