Organization Active NPI

Remagin, LLC

  • Ophthalmology Physician
  • Windermere, FL
National Provider Identifier
1710299151
Registry record updated Nov 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
106364 Issued in FL
Legal business name
REMAGIN, LLC
Practice address
4750 The Grove Dr
Suite 230
Windermere, FL 34786
Phone
(407) 704-3937
Fax
(407) 704-3920
NPI assigned
Jul 13, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2020

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

Authorized official

Name
Deepak Raja, MDNPI 1215143771
Title
Owner/MD
Phone
(407) 704-3937

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 106364 FL Primary

Addresses

Primary practice location

4750 The Grove Dr
Suite 230
Windermere, FL 34786

Mailing address

4750 The Grove Dr
Suite 230
Windermere, FL 34786
Phone (407) 704-3937

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101203001108 FL Part B Supplier - Clinic/Group Practice 3375738354 Receives reassigned benefits from 3 practitioners
Practice locations: Windermere, FL

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
10D2037503Remagin LLC4750 The Grove Dr Ste 230, Windermere, FL 34786Certificate of waiverFeb 29, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1278979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605744000000",
    "number": "1710299151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 THE GROVE DR",
            "address_2": "SUITE 230",
            "city": "WINDERMERE",
            "state": "FL",
            "postal_code": "34786",
            "telephone_number": "407-704-3937",
            "fax_number": "407-704-3920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4750 THE GROVE DR",
            "address_2": "SUITE 230",
            "city": "WINDERMERE",
            "state": "FL",
            "postal_code": "34786",
            "telephone_number": "407-704-3937",
            "fax_number": "407-704-3920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REMAGIN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-13",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A",
        "authorized_official_last_name": "RAJA",
        "authorized_official_first_name": "DEEPAK",
        "authorized_official_title_or_position": "OWNER/MD",
        "authorized_official_telephone_number": "407-704-3937",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "106364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Windermere, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2020; 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.