Retina Associates PA

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

ME0053221 Issued in FL

Legal business name

RETINA ASSOCIATES PA

Practice address

751 Oak St Ste 300
Jacksonville, FL 32204-3376

Phone

(904) 388-8446

Fax

(904) 384-6261

NPI assigned

Nov 9, 2005

Organization subpart

No

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

Authorized official

Name

Mansoor S. MughalNPI 1497905046

Title

MD

Phone

(904) 388-8446

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Interoperability endpoints

• Direct secure messaging: flambrou@jrafl.intellechartdirect.net

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mansoor S. Mughal, M.D.

  • Ophthalmology Physician
  • Jacksonville, FL
  • NPI 1497905046
  Medicare reassignment NPD Authorized official
• Amr L Dessouki, MD

  • Ophthalmology Physician
  • Campbell, CA
  • NPI 1013905389
  NPD (past)

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770681600000",
    "number": "1619958352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 OAK ST STE 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322043376",
            "telephone_number": "904-388-8446",
            "fax_number": "904-384-6261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 OAK ST STE 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322043376",
            "telephone_number": "904-388-8446",
            "fax_number": "904-384-6261"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Shircliff Way",
            "address_2": "Suite 715",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322044753",
            "country_code": "US",
            "telephone_number": "904-388-8446",
            "fax_number": "904-384-6261",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1563 Kingsley Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Orange Park",
            "state": "FL",
            "postal_code": "320734503",
            "country_code": "US",
            "telephone_number": "904-388-8446",
            "fax_number": "904-384-6261",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3636 University Blvd S Ste A6",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322164210",
            "country_code": "US",
            "telephone_number": "904-388-8446",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RETINA ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-09",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "status": "A",
        "authorized_official_last_name": "MUGHAL",
        "authorized_official_first_name": "MANSOOR",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "904-388-8446"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME0053221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "00394479A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "048036300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "180005784",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "05860",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "C12098",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "18BDCCP",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2026; 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.