Vitreo-Retinal Associates Medical Group

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

VITREO-RETINAL ASSOCIATES MEDICAL GROUP

Practice address

800 Fairmount Ave Ste 120
Pasadena, CA 91105-3151

Phone

(626) 440-9920

Fax

(626) 440-0351

NPI assigned

Jul 1, 2006

Organization subpart

No

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

Authorized official

Name

Lawrence Joseph Kondra, MD

Title

Partnership

Phone

(626) 440-9920

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Vitreo-Retinal Associates Medical Group

  • Ophthalmology Physician
  • Pomona, CA
  • NPI 1730191800
  NPPES parent name

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1514851200000",
    "number": "1245269356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 FAIRMOUNT AVE STE 120",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053151",
            "telephone_number": "626-440-9920",
            "fax_number": "626-440-0351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 FAIRMOUNT AVE STE 120",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053151",
            "telephone_number": "626-440-9920",
            "fax_number": "626-440-0351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITREO-RETINAL ASSOCIATES MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2018-01-02",
        "status": "A",
        "authorized_official_last_name": "KONDRA",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PARTNERSHIP",
        "authorized_official_telephone_number": "626-440-9920",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "180003746",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CS9651",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0046200",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "W11190",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vital Home Health Care, Inc
• Vitali Surgery Center
• Alexandra C Vite, NP
• Stephanie Andrea Viteri
• Jennifer L Vitez, DMD
• Jason Alexander Vivar
• Alicia Vivas
• Vivat Home Health Inc
• Jennifer Viveros
• Jocelyne Viveros

• Ophthalmology Physician in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2018; 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.