NPIMap

Organization Active NPI

Retina and Macula Specialists PS

  • Ophthalmology Physician
  • Renton, WA
National Provider Identifier
1710276001
Registry record updated Apr 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
RETINA AND MACULA SPECIALISTS PS
Practice address
1107 SW Grady Way
Suite 222
Renton, WA 98057-5217
Phone
(425) 255-1999
Fax
(425) 656-5086
NPI assigned
Apr 7, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2011

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

Authorized official

Name
Ms. Paulinne D Enz
Title
Office Manager
Phone
(253) 573-0948

Specialties & licenses 2

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

Addresses

Primary practice location

1107 SW Grady Way
Suite 222
Renton, WA 98057-5217

Mailing address

2914 S Alder St
Tacoma, WA 98409-4819
Phone (253) 573-0948

National Provider Directory

National Provider Directory
Tax ID family
Retina and Macula Specialists PS4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

1107 SW Grady Way
Ste 222
Renton, WA 98057
Phone (425) 255-1999

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1302134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302134400000",
    "number": "1710276001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2914 S ALDER ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984094819",
            "telephone_number": "253-573-0948",
            "fax_number": "253-573-0942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 SW GRADY WAY",
            "address_2": "SUITE 222",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980575217",
            "telephone_number": "425-255-1999",
            "fax_number": "425-656-5086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RETINA AND MACULA SPECIALISTS PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-07",
        "last_updated": "2011-04-07",
        "status": "A",
        "authorized_official_last_name": "ENZ",
        "authorized_official_first_name": "PAULINNE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "253-573-0948",
        "authorized_official_name_prefix": "Ms."
    },
    "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 Renton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2011; 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.