NPIMap

Organization Active NPI

Retina Consultants of Southern Colorado P C

  • Ophthalmology Physician
  • Colorado Springs, CO
National Provider Identifier
1720203862
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
28079 Issued in CO
Legal business name
RETINA CONSULTANTS OF SOUTHERN COLORADO P C
Practice address
2770 N Union Blvd
Suite 140
Colorado Springs, CO 80909-1183
Phone
(719) 473-9595
Fax
(719) 227-0669
NPI assigned
Apr 16, 2007
Last updated
Oct 5, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

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

Authorized official

Name
Christine Darlene Beal
Title
Operations Director
Phone
(719) 473-9595

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X 28079 CO Primary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X 38699 CO
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X 42148 CO

Addresses

Primary practice location

2770 N Union Blvd
Suite 140
Colorado Springs, CO 80909-1183

Mailing address

2770 N Union Blvd
Suite 140
Colorado Springs, CO 80909-1183
Phone (719) 473-9595

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040323000148 CO Part B Supplier - Clinic/Group Practice 8123914694 Receives reassigned benefits from 8 practitioners
2 other NPIs on this enrollment
Practice locations: Colorado Springs, CO; Pueblo, CO

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
Retina Consultants of Southern Colorado P C3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

2770 N Union Blvd
Ste 180
Colorado Springs, CO 80909
Phone (713) 418-4700

3711 Parker Blvd
Pueblo, CO 81008
Phone (719) 473-9595

Interoperability endpoints

  • Direct secure messaging: rsarrafizadeh@rcsc.intellechartdirect.net
  • Direct secure messaging: jluu@rcsc.intellechartdirect.net
  • Direct secure messaging: rrich@rcsc.intellechartdirect.net
  • Direct secure messaging: mosullivan@rcsc.intellechartdirect.net
  • Direct secure messaging: amartidis@rcsc.intellechartdirect.net
  • Direct secure messaging: staylor@rcsc.intellechartdirect.net
  • Direct secure messaging: nviruni@rcsc.intellechartdirect.net
  • Direct secure messaging: cronquillo@rcsc.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696464000000",
    "number": "1720203862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2770 N UNION BLVD",
            "address_2": "SUITE 140",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809091183",
            "telephone_number": "719-473-9595",
            "fax_number": "719-227-0669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2770 N UNION BLVD",
            "address_2": "SUITE 140",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809091183",
            "telephone_number": "719-473-9595",
            "fax_number": "719-227-0669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RETINA CONSULTANTS OF SOUTHERN COLORADO P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A",
        "authorized_official_last_name": "BEAL",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "DARLENE",
        "authorized_official_title_or_position": "OPERATIONS DIRECTOR",
        "authorized_official_telephone_number": "719-473-9595"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "CO",
            "license": "28079",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "CO",
            "license": "38699",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "CO",
            "license": "42148",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; 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.