Retina Consultants of Southern Cal Medical Associates Inc

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

RETINA CONSULTANTS OF SOUTHERN CAL MEDICAL ASSOCIATES INC

Practice address

9041 Magnolia Ave
Suite 207
Riverside, CA 92503-3900

Phone

(951) 788-0222

Fax

(951) 299-8090

NPI assigned

Dec 6, 2006

Organization subpart

No

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

Authorized official

Name

John Patrick Carlson, MDNPI 1215913199

Title

President

Phone

(951) 788-0222

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Interoperability endpoints

• Direct secure messaging: jchow@retinaconsultantsofsc.intellechartdirect.net

Practitioners 7

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

• John Patrick Carlson, MD

  • Ophthalmology Physician
  • Riverside, CA
  • NPI 1215913199
  Medicare reassignment Care Compare group NPD Authorized official
• Eric Chin, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Redlands, CA
  • NPI 1043442809
  Medicare reassignment Care Compare group NPD
• Jason Chow, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Riverside, CA
  • NPI 1639526072
  Medicare reassignment Care Compare group NPD
• Suzie Anush Kazaryan Gasparian, MD

  • Retina Specialist (Ophthalmology) Physician
  • Riverside, CA
  • NPI 1790280592
  Medicare reassignment Care Compare group NPD
• Richard Dominic Pesavento, M.D.

  • Ophthalmology Physician
  • Riverside, CA
  • NPI 1396721635
  Medicare reassignment NPD
• Kenneth O Sparks, M.D.

  • Ophthalmology Physician
  • Beverly Hills, CA
  • NPI 1598790263
  NPD
• Shil Kiritkumar Patel, M.D.

  • Ophthalmology Physician
  • Fishersville, VA
  • NPI 1750541553
  NPD (past)

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724889600000",
    "number": "1710046842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9041 MAGNOLIA AVE",
            "address_2": "SUITE 207",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033900",
            "telephone_number": "951-788-0222",
            "fax_number": "951-299-8090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9041 MAGNOLIA AVE",
            "address_2": "SUITE 207",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033900",
            "telephone_number": "951-788-0222",
            "fax_number": "951-299-8090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RETINA CONSULTANTS OF SOUTHERN CAL MEDICAL ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-788-0222",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Alyssa Retana
• Retina Institute of California Medical Group, a California Medical Par
• Ael Faith Retonel
• Sarah Elizabeth Reuss, ATC
• Bianca Marie Reveles
• Benita A Revies, AMFT

• Ophthalmology Physician in Riverside, CA
• Providers in Riverside, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; 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.