Retina Consultants PC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

RETINA CONSULTANTS PC

Practice address

3520 Walton Way Ext
Augusta, GA 30909-6605

Phone

(706) 481-9191

Fax

(706) 481-9197

NPI assigned

Dec 20, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Oksana M Demediuk, MD

Title

Vice President

Phone

(706) 481-9191

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• The Retina Eye Center Doing business as

Locations

Practitioners 2

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

• Russell K Daniel, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Aiken, SC
  • NPI 1376540260
  NPD (past)
• Kean T Oh, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Traverse City, MI
  • NPI 1780686485
  NPD (past)

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380153600000",
    "number": "1750445425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3520 WALTON WAY EXT",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309096605",
            "telephone_number": "706-481-9191",
            "fax_number": "706-481-9197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3520 WALTON WAY EXT",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309096605",
            "telephone_number": "706-481-9191",
            "fax_number": "706-481-9197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RETINA CONSULTANTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2013-09-26",
        "status": "A",
        "authorized_official_last_name": "DEMEDIUK",
        "authorized_official_first_name": "OKSANA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "706-481-9191",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GPA695",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP2817",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "55003385A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Retina Eye Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ophthalmology Physician in Augusta, GA
• Providers in Augusta, GA by specialty
• Ophthalmology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2013; 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.