NPIMap

Organization Active NPI

The Retina Group of Washington, PLLC

  • Ophthalmology Physician
  • Elkton, MD
National Provider Identifier
1619717345
Registry record updated Mar 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
THE RETINA GROUP OF WASHINGTON, PLLC
Practice address
360 E Pulaski Hwy Ste 1a
Elkton, MD 21921-6592
Phone
(410) 620-3600
NPI assigned
May 30, 2024
Organization subpart
Yes
Parent organization
THE RETINA GROUP OF WASHINGTON, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 23, 2025

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

Authorized official

Name
Steven Madreperla, MD, PHD
Title
President and Ceo
Phone
(214) 415-9671

Specialties & licenses 2

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

Addresses

Primary practice location

360 E Pulaski Hwy Ste 1a
Elkton, MD 21921-6592

Mailing address

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

National Provider Directory

National Provider Directory
Tax ID family
The Retina Group of Was48 organizations share this tax ID, including this one
Part of
The Retina Group of Was

Other organizations with this tax ID 47

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

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1717027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742688000000",
    "number": "1619717345",
    "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": "360 E PULASKI HWY STE 1A",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219216592",
            "telephone_number": "410-620-3600"
        }
    ],
    "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": "2024-05-30",
        "last_updated": "2025-03-23",
        "certification_date": "2025-03-23",
        "status": "A",
        "authorized_official_last_name": "MADREPERLA",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "214-415-9671",
        "authorized_official_credential": "MD, PHD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkton, MD

Sources for this page

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