Retina Specialist PC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

219303 Issued in NY

Legal business name

RETINA SPECIALIST PC

Practice address

20 W 13TH St
Suite 422
New York, NY 10011-7995

Phone

(212) 604-9800

Fax

(212) 242-4757

NPI assigned

Jun 24, 2006

Last updated

Mar 19, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John J Khadem, M.D., M.P.H.NPI 1477530012

Title

President

Phone

(212) 604-9800

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

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.

• John J Khadem, M.D., M.P.H.

  • Ophthalmology Physician
  • New York, NY
  • NPI 1477530012
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426723200000",
    "number": "1275569048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 W 13TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100117995",
            "telephone_number": "212-604-9800",
            "fax_number": "212-242-4757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 W 13TH ST",
            "address_2": "SUITE 422",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100117995",
            "telephone_number": "212-604-9800",
            "fax_number": "212-242-4757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RETINA SPECIALIST PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-24",
        "last_updated": "2015-03-19",
        "status": "A",
        "authorized_official_last_name": "KHADEM",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-604-9800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., M.P.H."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "219303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yudis Retig, OTR
• Retina Associates of New York,P.C.
• Retina Group P.C.
• Retina Group P.C.
• Retina Institute of New York, LLP
• Retinal Ambulatory Surgery Center of New York, Inc.
• Laszlo Retsagi, M.D.
• Rachel Retsky, MD
• Bethlehem Retta
• Anne Elizabeth Rettenberg, LCSW

• Ophthalmology Physician in New York, NY
• Providers in New York, NY by specialty
• Ophthalmology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2015; 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.