Philadelphia Retina Associates PC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

PHILADELPHIA RETINA ASSOCIATES PC

Practice address

2701 Holme Ave Ste 303
Philadelphia, PA 19152-2029

Phone

(215) 335-3088

Fax

(215) 335-0315

NPI assigned

May 27, 2006

Organization subpart

No

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

Authorized official

Name

Edward A Deqlin, M.D.

Title

President

Phone

(215) 335-3088

Specialties & licenses 2

Addresses

Other identifiers 4

Other names 1

• Edward A. Deqlin, M.D. PC Former legal business name

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 5

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

• Edward Alan Deglin, MD

  • Ophthalmology Physician
  • Philadelphia, PA
  • NPI 1164428744
  Medicare reassignment NPD
• Joshua M Greene, MD

  • Retina Specialist (Ophthalmology) Physician
  • Philadelphia, PA
  • NPI 1619978756
  Medicare reassignment NPD
• Anton M Kolomeyer, MD, PHD

  • Ophthalmology Physician
  • Vineland, NJ
  • NPI 1245573864

  PA

  Medicare reassignment NPD
• Robert M Carroll, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Philadelphia, PA
  • NPI 1932549771
  Medicare reassignment
• Hugo Manuel Linares, D.O.

  • Retina Specialist (Ophthalmology) Physician
  • Philadelphia, PA
  • NPI 1013143726
  Medicare reassignment

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1104873223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 HOLME AVE",
            "address_2": "SUITE 303",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191522029",
            "telephone_number": "215-335-3088",
            "fax_number": "215-335-0315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 HOLME AVE STE 303",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191522029",
            "telephone_number": "215-335-3088",
            "fax_number": "215-335-0315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILADELPHIA RETINA ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "DEQLIN",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-335-3088",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology, Retina Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE HEALTH PLAN EAST",
            "identifier": "0045476000",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0724403",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBC",
            "identifier": "149829",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3972",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edward A. Deqlin, M.D. PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Ophthalmology Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Ophthalmology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.