Organization Active NPI

Retina Center of Ohio, LLC

  • Ophthalmology Physician
  • South Euclid, OH
National Provider Identifier
1104229855
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
RETINA CENTER OF OHIO, LLC
Practice address
1161 S. Green Road
Suite 230
South Euclid, OH 44121-4129
Phone
(216) 382-3366
Fax
(216) 382-4959
NPI assigned
Oct 8, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Authorized official

Name
Mrs. Jessica Pietropinto
Title
Practice Manager
Phone
(216) 382-3366

Specialties & licenses 1

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

Addresses

Primary practice location

1161 S. Green Road
Suite 230
South Euclid, OH 44121-4129

Mailing address

1611 S Green Rd
Suite 306B
South Euclid, OH 44121-4129
Phone (216) 382-3366

Other identifiers 2

IdentifierTypeStateIssuer
0806837MedicaidOH
21874635700OtherOHWORKMAN'S COMP

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141118002474 OH Part B Supplier - Clinic/Group Practice 4284856790 Receives reassigned benefits from 1 practitioner
Practice locations: Cleveland, OH

National Provider Directory

National Provider Directory

Locations

1611 S Green Rd
Ste 230
South Euclid, OH 44121
Phone (216) 382-3366

1611 S Green Rd
Ste 306B
South Euclid, OH 44121
Phone (216) 291-3550

Interoperability endpoints

  • Direct secure messaging: shuang@rcoh.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 1

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": "1412726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742169600000",
    "number": "1104229855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 S GREEN RD",
            "address_2": "SUITE 306B",
            "city": "SOUTH EUCLID",
            "state": "OH",
            "postal_code": "441214129",
            "telephone_number": "216-382-3366",
            "fax_number": "216-382-4959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1161 S. GREEN ROAD",
            "address_2": "SUITE 230",
            "city": "SOUTH EUCLID",
            "state": "OH",
            "postal_code": "441214129",
            "telephone_number": "216-382-3366",
            "fax_number": "216-382-4959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RETINA CENTER OF OHIO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-08",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-12",
        "status": "A",
        "authorized_official_last_name": "PIETROPINTO",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "216-382-3366",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0806837",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKMAN'S COMP",
            "identifier": "21874635700",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Euclid, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2025; 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.