Organization Active NPI

The Retina Group of Washington, PLLC

  • Ophthalmology Physician
  • Fairfax, VA
National Provider Identifier
1720848708
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
THE RETINA GROUP OF WASHINGTON, PLLC
Practice address
8270 Willow Oaks Corporate Dr FL 6
Fairfax, VA 22031-4530
Phone
(703) 698-9335
Fax
(703) 207-0038
NPI assigned
Mar 19, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2024

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

Authorized official

Name
Steven A Madreperla, MD, PHD
Title
Owner/Ceo
Phone
(908) 458-8321

Specialties & licenses 1

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

Addresses

Primary practice location

8270 Willow Oaks Corporate Dr FL 6
Fairfax, VA 22031-4530

Mailing address

420 Mountain Ave FL 4
New Providence, NJ 07974-2736

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
49D2096417The Retina Group of Washington8270 Willow Oaks Corporate Drive, Fairfax, VA 22031Certificate of waiverSep 28, 2027

National Provider Directory

National Provider Directory
Tax ID family
The Retina Group of Was48 organizations share this tax ID, including this one

Other organizations with this tax ID 47

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

View all 47

Locations

8270 Willow Oaks Corporate Dr
Fairfax, VA 22031
Phone (571) 423-4250

NPI Registry JSON

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

{
    "created_epoch": "1710806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716422400000",
    "number": "1720848708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 MOUNTAIN AVE FL 4",
            "city": "NEW PROVIDENCE",
            "state": "NJ",
            "postal_code": "079742736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8270 WILLOW OAKS CORPORATE DR FL 6",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314530",
            "telephone_number": "703-698-9335",
            "fax_number": "703-207-0038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE RETINA GROUP OF WASHINGTON, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-19",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A",
        "authorized_official_last_name": "MADREPERLA",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "908-458-8321",
        "authorized_official_credential": "MD, PHD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.