Organization Active NPI

PH Retina Ophthalmology Care, PLLC

  • Retina Specialist (Ophthalmology) Physician
  • Nanuet, NY
National Provider Identifier
1114812690
Registry record updated Jun 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
Legal business name
PH RETINA OPHTHALMOLOGY CARE, PLLC
Practice address
25 Smith St Ste 414
Nanuet, NY 10954-2973
Phone
(845) 335-7234
Fax
(845) 335-7237
NPI assigned
Jun 12, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2025

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

Authorized official

Name
Dr. Paul Hahn, MD, PHDNPI 1043360704
Title
Physician
Phone
(845) 335-7234

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X
Retina Specialist (Ophthalmology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207WX0107X Primary

Addresses

Primary practice location

25 Smith St Ste 414
Nanuet, NY 10954-2973

Mailing address

25 Smith St Ste 414
Nanuet, NY 10954-2973
Phone (845) 335-7234

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250827000656 NY Part B Supplier - Clinic/Group Practice 5193226785 Receives reassigned benefits from 1 practitioner
Practice locations: Nanuet, NY

National Provider Directory

National Provider Directory

Locations

25 Smith St
Ste 414
Nanuet, NY 10954
Phone (845) 335-7234

Interoperability endpoints

  • Direct secure messaging: phahn@phretina.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": "1749686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749686400000",
    "number": "1114812690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 SMITH ST STE 414",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109542973",
            "telephone_number": "845-335-7234",
            "fax_number": "845-335-7237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 SMITH ST STE 414",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109542973",
            "telephone_number": "845-335-7234",
            "fax_number": "845-335-7237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PH RETINA OPHTHALMOLOGY CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-12",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A",
        "authorized_official_last_name": "HAHN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "845-335-7234",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, PHD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology, Retina Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nanuet, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.