Retina & Vitreous Consultants of Wi, LTD.

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

Legal business name

RETINA & VITREOUS CONSULTANTS OF WI, LTD.

Practice address

2600 N Mayfair Rd
Suite 901
Milwaukee, WI 53226-1309

Phone

(414) 774-3484

Fax

(414) 778-3445

NPI assigned

Mar 23, 2007

Organization subpart

No

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

Authorized official

Name

Sharath C Raja, MDNPI 1417953829

Title

President

Phone

(414) 774-3484

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

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

CLIA laboratory certificates

Locations

Interoperability endpoints

• Direct secure messaging: rgcoussa@rvcow.intellechartdirect.net
• Direct secure messaging: ntosi@rvcow.intellechartdirect.net
• Direct secure messaging: sraja@rvcow.intellechartdirect.net
• Direct secure messaging: lshaw@rvcow.intellechartdirect.net

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Razek Georges Coussa, MDCM, MPHIL, MENG

  • Retina Specialist (Ophthalmology) Physician
  • Milwaukee, WI
  • NPI 1700362522
  Medicare reassignment Care Compare group NPD
• Lincoln Shaw

  • Retina Specialist (Ophthalmology) Physician
  • Milwaukee, WI
  • NPI 1003347584
  Medicare reassignment Care Compare group NPD
• Nicholas H. Tosi, MD

  • Retina Specialist (Ophthalmology) Physician
  • Milwaukee, WI
  • NPI 1891924650
  Medicare reassignment Care Compare group NPD
• Sharath C Raja, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Milwaukee, WI
  • NPI 1417953829
  Authorized official Same address or phone
• Kevin Francis Elwood, MD

  • Retina Specialist (Ophthalmology) Physician
  • Milwaukee, WI
  • NPI 1083243802
  NPD
• Heather L Addis, RN

  • Registered Nurse
  • Milwaukee, WI
  • NPI 1952457509
  NPD (past)
• Cynthia S Bujanovich, RN

  • Registered Nurse
  • Milwaukee, WI
  • NPI 1598811135
  NPD (past)
• Tracie L Gurda

  • Surgical Technologist
  • Milwaukee, WI
  • NPI 1306992870
  NPD (past)
• Sue A Larson, RN

  • Registered Nurse
  • Milwaukee, WI
  • NPI 1811043458
  NPD (past)
• Jay A. Met, MD

  • Ophthalmology Physician
  • Milwaukee, WI
  • NPI 1013963107
  NPD (past)
• Joseph M Pfiffner, RN

  • Registered Nurse
  • Milwaukee, WI
  • NPI 1376699900
  NPD (past)

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624406400000",
    "number": "1114044435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 N MAYFAIR RD",
            "address_2": "SUITE 901",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532261309",
            "telephone_number": "414-774-3484",
            "fax_number": "414-778-3445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 N MAYFAIR RD",
            "address_2": "SUITE 901",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532261309",
            "telephone_number": "414-774-3484",
            "fax_number": "414-778-3445"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13133 N Port Washington Rd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Mequon",
            "state": "WI",
            "postal_code": "530972420",
            "country_code": "US",
            "telephone_number": "262-240-0457",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6815 118th Ave Ste 227",
            "address_purpose": "LOCATION",
            "city": "Kenosha",
            "state": "WI",
            "postal_code": "531428420",
            "country_code": "US",
            "telephone_number": "262-524-9323",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2801 W Kinnickinnic River Pkwy Ste 350",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532153695",
            "country_code": "US",
            "telephone_number": "414-649-4660",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1111 Delafield St Ste 227",
            "address_purpose": "LOCATION",
            "city": "Waukesha",
            "state": "WI",
            "postal_code": "531883400",
            "country_code": "US",
            "telephone_number": "262-524-9323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RETINA & VITREOUS CONSULTANTS OF WI, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A",
        "authorized_official_last_name": "RAJA",
        "authorized_official_first_name": "SHARATH",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-774-3484",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology, Retina Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32708400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Brianna Jean Reti
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• Janet Retseck, M.D.
• Renee E Rettler, O.T.R.
• Susan M Retzack, MD

• Retina Specialist (Ophthalmology) Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Retina Specialist (Ophthalmology) Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; 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.