Southern New England Retina Associates, PC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

SOUTHERN NEW ENGLAND RETINA ASSOCIATES, PC

Practice address

30 Manmar Drive
Suite 2
Plainville, MA 02703-2271

Phone

(508) 695-9550

Fax

(508) 695-9505

NPI assigned

May 3, 2006

Last updated

Jul 23, 2013By the provider in NPPES

Organization subpart

Yes

Parent organization

SOUTHERN NEW ENGLAND RETINA ASSOCIATIONAs reported in NPPES

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

Authorized official

Name

Dr. Magdalena G Krzystolik, M.D.

Title

President

Phone

(508) 695-9550

Specialties & licenses 1

Addresses

Other identifiers 5

Part of

Southern NE Ret Assoc

Locations

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374537600000",
    "number": "1396703542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 MAN MAR DR",
            "address_2": "SUITE 2",
            "city": "PLAINVILLE",
            "state": "MA",
            "postal_code": "027622271",
            "telephone_number": "508-695-9550",
            "fax_number": "508-695-9505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 MANMAR DRIVE",
            "address_2": "SUITE 2",
            "city": "PLAINVILLE",
            "state": "MA",
            "postal_code": "027032271",
            "telephone_number": "508-695-9550",
            "fax_number": "508-695-9505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN NEW ENGLAND RETINA ASSOCIATES, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHERN NEW ENGLAND RETINA ASSOCIATION",
        "enumeration_date": "2006-05-03",
        "last_updated": "2013-07-23",
        "status": "A",
        "authorized_official_last_name": "KRZYSTOLIK",
        "authorized_official_first_name": "MAGDALENA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "508-695-9550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "M19151",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7246790",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9004676",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "624129",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9762591",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Silver Fern Practice, LLC (Highbar)
• Simple Journee Inc
• Melissa Slegona, LICSW
• Jessica Soler
• Jessica Sorge
• William David Spear, LCSW
• Kristina Spellman, RD
• Lindsey Spindel, PT
• Karla Stallworth, LMHC
• Medghine Stinfort

• Ophthalmology Physician in Plainville, MA
• Providers in Plainville, MA by specialty
• Ophthalmology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2013; 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.