Harbor Retina Center PLLC

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

Legal business name

HARBOR RETINA CENTER PLLC

Practice address

3273 Davison Rd Ste 1
Lapeer, MI 48446-2902

Phone

(810) 356-9700

NPI assigned

Aug 21, 2020

Organization subpart

No

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

Authorized official

Name

Deepak ManglaNPI 1942648902

Title

Physician

Phone

(810) 356-9700

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

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

• Deepak Mangla, M.D.

  • Ophthalmology Physician
  • Lapeer, MI
  • NPI 1942648902
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1597968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658102400000",
    "number": "1639781545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3273 DAVISON RD STE 1",
            "city": "LAPEER",
            "state": "MI",
            "postal_code": "484462902",
            "telephone_number": "810-356-9700",
            "fax_number": "810-356-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3273 DAVISON RD STE 1",
            "city": "LAPEER",
            "state": "MI",
            "postal_code": "484462902",
            "telephone_number": "810-356-9700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2950 W Square Lake Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480985725",
            "country_code": "US",
            "telephone_number": "248-983-5250",
            "fax_number": "248-983-5250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HARBOR RETINA CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-21",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A",
        "authorized_official_last_name": "MANGLA",
        "authorized_official_first_name": "DEEPAK",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "810-356-9700"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology, Retina Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katy Hall
• Martha Jane Hall, LLPC
• Kristyana Rae Hamblin
• Hamilton Community Health Network, Inc
• Cecilia Hammond, CF-SLP
• Theresa Hargrove
• Joseph Schell Harman, LPC
• Allison Paige Harris
• Jeffrey Lynn Harris, D.O.
• Todd Lincoln Harris, O.D.

• Retina Specialist (Ophthalmology) Physician in Lapeer, MI
• Providers in Lapeer, MI by specialty
• Retina Specialist (Ophthalmology) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2022; 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.