Organization Active NPI

The Retina Group of Washington, PLLC

  • Ophthalmology Physician
  • Bowie, MD
National Provider Identifier
1194585166
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
THE RETINA GROUP OF WASHINGTON, PLLC
Practice address
16901 Melford Blvd Ste 111
Bowie, MD 20715-4449
Phone
(301) 805-5395
Fax
(301) 805-5396
NPI assigned
Mar 19, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2024

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

Authorized official

Name
Steven A Madreperla, MD, PHD
Title
Owner/Ceo
Phone
(908) 458-8321

Specialties & licenses 1

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

Addresses

Primary practice location

16901 Melford Blvd Ste 111
Bowie, MD 20715-4449

Mailing address

420 Mountain Ave FL 4
New Providence, NJ 07974-2736

National Provider Directory

National Provider Directory
Tax ID family
The Retina Group of Was48 organizations share this tax ID, including this one

Other organizations with this tax ID 47

Organizations that report the same tax identification number in the National Provider Directory.

View all 47

Locations

16901 Melford Blvd
Ste 111
Bowie, MD 20715
Phone (301) 805-5395

NPI Registry JSON

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

{
    "created_epoch": "1710806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716422400000",
    "number": "1194585166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 MOUNTAIN AVE FL 4",
            "city": "NEW PROVIDENCE",
            "state": "NJ",
            "postal_code": "079742736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16901 MELFORD BLVD STE 111",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207154449",
            "telephone_number": "301-805-5395",
            "fax_number": "301-805-5396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE RETINA GROUP OF WASHINGTON, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-19",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A",
        "authorized_official_last_name": "MADREPERLA",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "908-458-8321",
        "authorized_official_credential": "MD, PHD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.