Ridley Creek Retina LLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

RIDLEY CREEK RETINA LLC

Practice address

200 E State St Ste 303
Media, PA 19063-3434

Phone

(610) 892-1708

Fax

(610) 892-8766

NPI assigned

Sep 23, 2020

Last updated

Dec 23, 2025By 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. Jason Lange, MDNPI 1174937775

Title

President

Phone

(610) 892-1708

Specialties & licenses 4

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 4

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.

• Jason Lange, M.D.

  • Ophthalmology Physician
  • Media, PA
  • NPI 1174937775

  Internal Medicine

  Medicare reassignment NPD Authorized official
• Weiye Li, M.D.

  • Ophthalmology Physician
  • Philadelphia, PA
  • NPI 1659340420
  Medicare reassignment NPD
• Andrea Saxon McGuinness, M.D.

  • Ophthalmology Physician
  • Ridley Park, PA
  • NPI 1538240700
  Medicare reassignment NPD
• Maximilian R. Padilla, M.D.

  • Ophthalmology Physician
  • Fort Myers, FL
  • NPI 1235557166

  PA

  Medicare reassignment NPD

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

{
    "created_epoch": "1600819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766448000000",
    "number": "1417564592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E STATE ST STE 303",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190633434",
            "telephone_number": "610-892-1708",
            "fax_number": "610-892-8766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E STATE ST STE 303",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190633434",
            "telephone_number": "610-892-1708",
            "fax_number": "610-892-8766"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6532 Bayshore Blvd",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336115505",
            "country_code": "US",
            "telephone_number": "610-892-1708",
            "fax_number": "610-892-8766",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RIDLEY CREEK RETINA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-23",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A",
        "authorized_official_last_name": "LANGE",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-892-1708",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.ridleycreekretina.com",
            "affiliation": "N",
            "endpointDescription": "Website",
            "address_1": "200 E State St Ste 105",
            "city": "Media",
            "state": "PA",
            "country_code": "US",
            "postal_code": "190633434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Riddle Memorial Hospital (RMH - HB/SNF)
• Riddle Memorial Hospital - HB / HHA
• Riddle Surgical Center LLC
• Riddle Village (Monticello House at Riddle Village)
• Riddle Village
• Karen Pearce Riggs, M.D.
• Rebecca Rinehart, RD, LD
• Denise Ring
• Kimberly J Ritchie, APN
• Tenesa Rivera Jeffress, MD

• Ophthalmology Physician in Media, PA
• Providers in Media, PA by specialty
• Ophthalmology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2025; 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.