NPIMap

Organization Active NPI

Retinovitreous Associates LTD

  • Ophthalmology Physician
  • Plymouth Meeting, PA
National Provider Identifier
1659326452
Registry record updated Jun 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
RETINOVITREOUS ASSOCIATES LTD
Practice address
4060 Butler Pike
Suite 200
Plymouth Meeting, PA 19462-1560
Phone
(800) 331-6634
Fax
(267) 420-1362
NPI assigned
May 23, 2006
Last updated
Jun 26, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2025

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

Authorized official

Name
Courtney Sheppard
Title
Cao/Cfo
Phone
(800) 331-6634

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X NU Primary
Retina Specialist (Ophthalmology) Physician 207WX0107X NU

Addresses

Primary practice location

4060 Butler Pike
Suite 200
Plymouth Meeting, PA 19462-1560

Mailing address

4060 Butler Pike
Suite 200
Plymouth Meeting, PA 19462-1560
Phone (800) 331-6634

Other practice location 1

100 Presidential Blvd Ste 100
Bala Cynwyd, PA 19004-1108
Phone (800) 331-6634

Other practice location 2

5325 Northgate Dr Ste 103
Bethlehem, PA 18017-9412
Phone (800) 331-6634

Other practice location 3

727 Welsh Rd Ste 206
Huntingdon Valley, PA 19006-6311
Phone (800) 331-6634

Other practice location 4

234 Mall Blvd Ste 200
King Of Prussia, PA 19406-2970
Phone (800) 331-6634

Other practice location 5

820 Town Center Dr Ste 200-1
Langhorne, PA 19047-1785
Phone (800) 331-6634

Other practice location 6

125 Medical Campus Dr Ste 315
Lansdale, PA 19446-7205
Phone (800) 331-6634

Other practice location 7

8025 Roosevelt Blvd Fl 1
Philadelphia, PA 19152-3000
Phone (800) 331-6634

Other practice location 8

2624 Westview Dr
Wyomissing, PA 19610
Phone (800) 331-6634

Other practice location 9

840 Walnut St Ste 1020
Philadelphia, PA 19107-5109
Phone (800) 331-6634

Other practice location 10

3855 W Chester Pike Ste 260
Newtown Square, PA 19073-2304
Phone (800) 331-6634

Other practice location 11

1 Crescent Dr Ste 400
Philadelphia, PA 19112-1015
Phone (800) 331-6634

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040608000300 PA Part B Supplier - Clinic/Group Practice 2961485412 Receives reassigned benefits from 39 practitioners
1 other NPI on this enrollment
Practice locations: Wyomissing, PA; Tamaqua, PA; Plymouth Meeting, PA; Philadelphia, PA; Newtown Square, PA; Langhorne, PA; Lansdale, PA; Bala Cynwyd, PA…

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D1069953Retinovitreous Associates LTD840 Walnut St Suite 1015, Philadelphia, PA 19107Certificate of waiverMay 7, 2028

National Provider Directory

National Provider Directory
Tax ID family
Mid Atlantic Retina2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

1523 Concord Pike
Ste 101
Wilmington, DE 19803
Phone (302) 351-1087

5325 Northgate Dr
Ste 103
Bethlehem, PA 18017
Phone (610) 691-7015

300 Plaza Ct
Ste A
East Stroudsburg, PA 18301
Phone (570) 421-8842

727 Welsh Rd
Ste 206
Huntingdon Vy, PA 19006
Phone (215) 938-0740

234 Mall Blvd
Ste 200
King of Prussia, PA 19406

125 Medical Campus Dr
Ste 315
Lansdale, PA 19446
Phone (215) 361-6142

1 Crescent Dr
Ste 400
Philadelphia, PA 19112

8025 Roosevelt Blvd
Fl 1
Philadelphia, PA 19152

4060 Butler Pike
Ste 200
Plymouth Meeting, PA 19462

Interoperability endpoints

  • Direct secure messaging: akuriyan@midatlret.intellechartdirect.net
  • Direct secure messaging: aobeid@midatlret.intellechartdirect.net
  • Direct secure messaging: aorlin@midatlret.intellechartdirect.net
  • Direct secure messaging: crichards@midatlret.intellechartdirect.net
  • Direct secure messaging: cschmidt@midatlret.intellechartdirect.net
  • Direct secure messaging: dconnors@midatlret.intellechartdirect.net
  • Direct secure messaging: dfell@midatlret.intellechartdirect.net
  • Direct secure messaging: jdeaner@midatlret.intellechartdirect.net
  • Direct secure messaging: jmuste@midatlret.intellechartdirect.net
  • Direct secure messaging: jpulido@midatlret.intellechartdirect.net
  • Direct secure messaging: juhr@midatlret.intellechartdirect.net
  • Direct secure messaging: lacababerrocal@midatlret.intellechartdirect.net
  • Direct secure messaging: mcohen@midatlret.intellechartdirect.net
  • Direct secure messaging: myu@midatlret.intellechartdirect.net
  • Direct secure messaging: nbommakanti@midatlret.intellechartdirect.net
  • Direct secure messaging: oadams@midatlret.intellechartdirect.net
  • Direct secure messaging: sfoxman@midatlret.intellechartdirect.net
  • Direct secure messaging: spatel@midatlret.intellechartdirect.net
  • Direct secure messaging: szafar@midatlret.intellechartdirect.net
  • Direct secure messaging: tbowe@midatlret.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 48

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.

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750896000000",
    "number": "1659326452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4060 BUTLER PIKE",
            "address_2": "SUITE 200",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194621560",
            "telephone_number": "800-331-6634",
            "fax_number": "267-420-1362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4060 BUTLER PIKE",
            "address_2": "SUITE 200",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194621560",
            "telephone_number": "800-331-6634",
            "fax_number": "267-420-1362"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Presidential Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Bala Cynwyd",
            "state": "PA",
            "postal_code": "190041108",
            "country_code": "US",
            "telephone_number": "800-331-6634",
            "fax_number": "610-667-1328",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5325 Northgate Dr Ste 103",
            "address_purpose": "LOCATION",
            "city": "Bethlehem",
            "state": "PA",
            "postal_code": "180179412",
            "country_code": "US",
            "telephone_number": "800-331-6634",
            "fax_number": "610-691-6817",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "727 Welsh Rd Ste 206",
            "address_purpose": "LOCATION",
            "city": "Huntingdon Valley",
            "state": "PA",
            "postal_code": "190066311",
            "country_code": "US",
            "telephone_number": "800-331-6634",
            "fax_number": "215-947-9324",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "234 Mall Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "King Of Prussia",
            "state": "PA",
            "postal_code": "194062970",
            "country_code": "US",
            "telephone_number": "800-331-6634",
            "fax_number": "484-370-8832",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "820 Town Center Dr Ste 200-1",
            "address_purpose": "LOCATION",
            "city": "Langhorne",
            "state": "PA",
            "postal_code": "190471785",
            "country_code": "US",
            "telephone_number": "800-331-6634",
            "fax_number": "215-752-2420",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "125 Medical Campus Dr Ste 315",
            "address_purpose": "LOCATION",
            "city": "Lansdale",
            "state": "PA",
            "postal_code": "194467205",
            "country_code": "US",
            "telephone_number": "800-331-6634",
            "fax_number": "215-361-6143",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8025 Roosevelt Blvd Fl 1",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191523000",
            "country_code": "US",
            "telephone_number": "800-331-6634",
            "fax_number": "215-333-3414",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2624 Westview Dr",
            "address_purpose": "LOCATION",
            "city": "Wyomissing",
            "state": "PA",
            "postal_code": "19610",
            "country_code": "US",
            "telephone_number": "800-331-6634",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "840 Walnut St Ste 1020",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191075109",
            "country_code": "US",
            "telephone_number": "800-331-6634",
            "fax_number": "215-825-2443",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3855 W Chester Pike Ste 260",
            "address_purpose": "LOCATION",
            "city": "Newtown Square",
            "state": "PA",
            "postal_code": "190732304",
            "country_code": "US",
            "telephone_number": "800-331-6634",
            "fax_number": "610-353-4192",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Crescent Dr Ste 400",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191121015",
            "country_code": "US",
            "telephone_number": "800-331-6634",
            "fax_number": "215-218-7259",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RETINOVITREOUS ASSOCIATES LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A",
        "authorized_official_last_name": "SHEPPARD",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_title_or_position": "CAO/CFO",
        "authorized_official_telephone_number": "800-331-6634"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth Meeting, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.