Retina Consultants San Diego Inc

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

RETINA CONSULTANTS SAN DIEGO INC

Practice address

9850 Genesee Ave
Suite 700
La Jolla, CA 92037-1224

Phone

(858) 558-9666

Fax

(858) 558-1941

NPI assigned

May 13, 2006

Organization subpart

No

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

Authorized official

Name

Jocelin Ing

Title

Practice Administrator

Phone

(858) 500-7815

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Retina Consultants San Diego Inc Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Retina Consultants San Diego Inc

  • Ophthalmology Physician
  • Poway, CA
  • NPI 1790736098

  O20040826001499

  Same enrollment

Tax ID family

Retina Consultants2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Retina Consultants San Diego Inc

  • Ophthalmology Physician
  • Poway, CA
  • NPI 1790736098
  NPD tax ID

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)…

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Ammar, MD

  • Retina Specialist (Ophthalmology) Physician
  • Poway, CA
  • NPI 1982099115
  NPD
• Anne Marie Hanneken, MD

  • Ophthalmology Physician
  • La Jolla, CA
  • NPI 1699876011
  NPD
• Atul Kumar Jain, M.D.

  • Ophthalmology Physician
  • San Diego, CA
  • NPI 1194905711
  NPD
• Thomas Adriano McInnes Lazzarini, MD

  • Retina Specialist (Ophthalmology) Physician
  • San Diego, CA
  • NPI 1477088979
  NPD
• Nikolas London, M.D.

  • Ophthalmology Physician
  • San Diego, CA
  • NPI 1730418849
  NPD
• Lon Scott Poliner, M.D.

  • Ophthalmology Physician
  • Poway, CA
  • NPI 1720038458
  NPD

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

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707177600000",
    "number": "1366493546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12630 MONTE VISTA RD",
            "address_2": "SUITE 104",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642526",
            "telephone_number": "858-451-1911",
            "fax_number": "858-451-0566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9850 GENESEE AVE",
            "address_2": "SUITE 700",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371224",
            "telephone_number": "858-558-9666",
            "fax_number": "858-558-1941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RETINA CONSULTANTS SAN DIEGO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-13",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A",
        "authorized_official_last_name": "ING",
        "authorized_official_first_name": "JOCELIN",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "858-500-7815"
    },
    "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": "BLUE SHIELD",
            "identifier": "ZZZ30299Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0045281",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DA1466",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Retina Consultants San Diego Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Dawn Rens, DDS
• Reproductive Partners Medical Group la Jolla, Inc
• Residence Care Inc.
• Karen Resnick
• Jamie Layne Resnik, MD
• Retina Institute of California Medical Group, a California Medical Par
• Retina Institute of California Medical Group, a California Medical Par
• Tristan Jayson Retuya, MS OTR/L
• Revive Rejuvenation Center Anti Aging Regenerative Center Inc
• Caitlin Reyes, PHARMD

• Ophthalmology Physician in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2024; 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.