NPIMap

Organization Active NPI

Rockford Retina Clinic, S.C.

  • Ophthalmology Physician
  • Rockford, IL
National Provider Identifier
1437105012
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
ROCKFORD RETINA CLINIC, S.C.
Practice address
1075 Featherstone Rd
Ste 10
Rockford, IL 61107-5906
Phone
(815) 395-1157
NPI assigned
May 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Sina Bahmanyar, MDNPI 1174579577
Title
President
Phone
(815) 395-1157

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

1075 Featherstone Rd
Ste 10
Rockford, IL 61107-5906

Mailing address

6785 Weaver Rd
Ste D
Rockford, IL 61114-8055

National Provider Directory

National Provider Directory

Locations

973 Featherstone Rd
Rockford, IL 61107
Phone (815) 395-1157

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1437105012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6785 WEAVER RD",
            "address_2": "STE D",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611148055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 FEATHERSTONE RD",
            "address_2": "STE 10",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075906",
            "telephone_number": "815-395-1157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKFORD RETINA CLINIC, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BAHMANYAR",
        "authorized_official_first_name": "SINA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-395-1157",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.