NPIMap

Organization Active NPI

The Retina Group of Washington, PLLC

  • Optometrist
  • Havre de Grace, MD
National Provider Identifier
1568201416
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
THE RETINA GROUP OF WASHINGTON, PLLC
Practice address
2023 Pulaski Hwy
Havre de Grace, MD 21078-2137
Phone
(410) 939-6477
NPI assigned
May 21, 2024
Last updated
May 21, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
THE RETINA GROUP OF WASHINGTON, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 21, 2024

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

Authorized official

Name
Steven A Madreperla, MD, PHDNPI 1013925254
Title
President and Ceo
Phone
(908) 458-8333

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X Primary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X

Addresses

Primary practice location

2023 Pulaski Hwy
Havre de Grace, MD 21078-2137

Mailing address

420 Mountain Ave FL 4
New Providence, NJ 07974-2736

National Provider Directory

National Provider Directory
Tax ID family
Retina Group of Washing48 organizations share this tax ID, including this one
Part of
Retina Group of Washing

Other organizations with this tax ID 47

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

View all 47

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": "1716249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716249600000",
    "number": "1568201416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 MOUNTAIN AVE FL 4",
            "city": "NEW PROVIDENCE",
            "state": "NJ",
            "postal_code": "079742736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2023 PULASKI HWY",
            "city": "HAVRE DE GRACE",
            "state": "MD",
            "postal_code": "210782137",
            "telephone_number": "410-939-6477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE RETINA GROUP OF WASHINGTON, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE RETINA GROUP OF WASHINGTON, PLLC",
        "enumeration_date": "2024-05-21",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A",
        "authorized_official_last_name": "MADREPERLA",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "908-458-8333",
        "authorized_official_credential": "MD, PHD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Havre de Grace, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; 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.