NPIMap

Organization Active NPI

Retina Consultants PC

  • Ophthalmology Physician
  • Manchester, CT
National Provider Identifier
1093748071
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
RETINA CONSULTANTS PC
Practice address
191 Main St
Manchester, CT 06042-3556
Phone
(860) 646-7704
Fax
(860) 647-7340
NPI assigned
Jul 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Authorized official

Name
Mrs. Lisa Ann Deary
Title
Office Manager
Phone
(860) 646-7704

Specialties & licenses 1

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

Addresses

Primary practice location

191 Main St
Manchester, CT 06042-3556

Mailing address

191 Main St
Manchester, CT 06042-3556
Phone (860) 646-7704

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071212000484 CT Part B Supplier - Clinic/Group Practice 5799875951 Receives reassigned benefits from 7 practitioners
Practice locations: Cromwell, CT; Enfield, CT; Farmington, CT; Hartford, CT; Manchester, CT

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
07D2286011Retina Consultants, P C191 Main St, 2ND Floor, Manchester, CT 06042Certificate of waiverJul 20, 2027

National Provider Directory

National Provider Directory

Locations

80 Shunpike Rd
Unit 103
Cromwell, CT 06416
Phone (860) 788-6569

85 Freshwater Blvd
Enfield, CT 06082
Phone (860) 741-4300

5 Two Mile Rd
Farmington, CT 06032
Phone (860) 409-7800

5 Two Mile Rd
Ste 260
Farmington, CT 06032

85 Seymour St
Ste 882
Hartford, CT 06106

85 Seymour St
Ste 825
Hartford, CT 06106
Phone (860) 621-1896

43 Woodland St
Ste 100
Hartford, CT 06105
Phone (860) 527-9020

191 Main St
Ste 101
Manchester, CT 06042

Interoperability endpoints

  • Direct secure messaging: tnanda@retinact.intellechartdirect.net
  • FHIR API: https://fhir4.healow.com/fhir/r4/FCEACA
  • Direct secure messaging: apacker@retinact.intellechartdirect.net
  • Direct secure messaging: nrudnick@retinact.intellechartdirect.net
  • Direct secure messaging: jneuwirth@retinact.intellechartdirect.net
  • Direct secure messaging: pjudson@retinact.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 10

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": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690848000000",
    "number": "1093748071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 MAIN ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060423556",
            "telephone_number": "860-646-7704",
            "fax_number": "860-647-7340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 MAIN ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060423556",
            "telephone_number": "860-646-7704",
            "fax_number": "860-647-7340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RETINA CONSULTANTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A",
        "authorized_official_last_name": "DEARY",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "860-646-7704",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.