Active NPI
Maryland Retina Institute LLC
- Retina Specialist (Ophthalmology) Physician
- Olney, MD
National Provider Identifier
1568973444
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Retina Specialist (Ophthalmology) Physician
- Legal business name
- MARYLAND RETINA INSTITUTE LLC
- Practice address
- 2919 Olney Sandy Spring Rd Ste D
Olney, MD 20832 - Phone
- (301) 876-4900
- NPI assigned
- Oct 18, 2017
- Last updated
- Jun 14, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Raza Murtaza Shah, MD
- Title
- Physician
- Phone
- (301) 876-4900
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Retina Specialist (Ophthalmology) Physician | 207WX0107X | NU | Primary |
Addresses
Primary practice location
2919 Olney Sandy Spring Rd Ste D
Olney, MD 20832
Mailing address
2919 Olney Sandy Spring Rd Ste D
Olney, MD 20832-1589
Phone (301) 876-4900
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 07207311 | Other | MD | AMERIGROUP |
| 1205098910 | Other | MD | MARYLAND PHYSICIANS CARE |
| 49280003 | Other | MD | CAREFIRST BLUECROSS BLUESHIELD |
| 1205098910 | Other | MD | HIGHMARK BLUESHIELD |
| 1205098910 | Other | MD | UNITEDHEALTHCARE |
| 658406300 | Medicaid | MD | |
| 1205098910 | Other | MD | CIGNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
Enrollment records 1
National Provider Directory
National Provider Directory- Tax ID family
- Maryland Retina Institute LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Medical Specialty Clinic/Center
- Olney, MD
- NPI 1427890912
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": "1508284800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1528934400000",
"number": "1568973444",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2919 OLNEY SANDY SPRING RD STE D",
"city": "OLNEY",
"state": "MD",
"postal_code": "208321589",
"telephone_number": "301-876-4900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2919 OLNEY SANDY SPRING RD STE D",
"city": "OLNEY",
"state": "MD",
"postal_code": "20832",
"telephone_number": "301-876-4900"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MARYLAND RETINA INSTITUTE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-10-18",
"last_updated": "2018-06-14",
"status": "A",
"authorized_official_last_name": "SHAH",
"authorized_official_first_name": "RAZA",
"authorized_official_middle_name": "MURTAZA",
"authorized_official_title_or_position": "PHYSICIAN",
"authorized_official_telephone_number": "301-876-4900",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207WX0107X",
"taxonomy_group": "",
"desc": "Ophthalmology, Retina Specialist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP",
"identifier": "07207311",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MARYLAND PHYSICIANS CARE",
"identifier": "1205098910",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST BLUECROSS BLUESHIELD",
"identifier": "49280003",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUESHIELD",
"identifier": "1205098910",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITEDHEALTHCARE",
"identifier": "1205098910",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "658406300",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "1205098910",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Olney, MD
- Heidi Martino, SLP
- Mimi Pokua Martins, M.D
- Maryland CVS Pharmacy, L.L.C. (CVS Pharmacy # 01431)
- Maryland Oncology Hematology, PA
- Maryland Retina Institute LLC
- Maryland Rheumatology
- Maryland Smiles in Olney LLC (Olney Dental Wellness)
- Maryland Sportscare & Rehab LLC (Pivot Physical Therapy of Maryland)
- Maryland Visiting Providers LLC
- Denika Lynette Mason
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2018; 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.