Southeast Retina Center PC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

SOUTHEAST RETINA CENTER PC

Practice address

3685 Wheeler Rd
Ste 201
Augusta, GA 30909-6440

Phone

(706) 650-0061

Fax

(706) 650-0064

NPI assigned

Dec 14, 2005

Organization subpart

No

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

Authorized official

Name

Kevin Becker

Title

Cfo

Phone

(470) 243-2259

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in GA, SC2 enrollments

Enrollment records 2

Locations

Practitioners 9

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

• Dennis Michael Marcus, M.D.

  • Ophthalmology Physician
  • Augusta, GA
  • NPI 1851376776

  SC

  Medicare reassignment Care Compare group NPD
• Harinderjit Singh, M.D.

  • Ophthalmology Physician
  • Augusta, GA
  • NPI 1235115890
  Medicare reassignment Care Compare group NPD
• Tomasz Adam Wiraszka, MD

  • Retina Specialist (Ophthalmology) Physician
  • Augusta, GA
  • NPI 1346477114

  SC

  Medicare reassignment Care Compare group NPD
• Diego Gabriel Espinosa Heidmann, M.D.

  • Ophthalmology Physician
  • Greenville, SC
  • NPI 1891913380

  GA

  Medicare reassignment NPD
• Kunyong Xu, MD

  • Retina Specialist (Ophthalmology) Physician
  • Phoenix, AZ
  • NPI 1356877781

  GA, SC, Single Specialty

  Medicare reassignment NPD
• Doan Tam Bloomquist, M.D

  • Ophthalmology Physician
  • Augusta, GA
  • NPI 1700178308

  SC

  Medicare reassignment
• Julian J. Nussbaum, MD

  • Retina Specialist (Ophthalmology) Physician
  • Augusta, GA
  • NPI 1528167699
  NPD (past)
• Todd Andrew Schnobrich, OD

  • Optometrist
  • Pooler, GA
  • NPI 1760588636
  NPD (past)
• Scott Michael Anfinson, M.D.

  • Ophthalmology Physician
  • Bluffton, SC
  • NPI 1285678029
  NPD (past)

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777334400000",
    "number": "1760467682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11407",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352468575",
            "telephone_number": "864-359-1308",
            "fax_number": "239-496-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3685 WHEELER RD",
            "address_2": "STE 201",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309096440",
            "telephone_number": "706-650-0061",
            "fax_number": "706-650-0064"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "311 Fluker St",
            "address_purpose": "LOCATION",
            "city": "Thomson",
            "state": "GA",
            "postal_code": "308242108",
            "country_code": "US",
            "telephone_number": "706-650-0061",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 Fieldstone Dr",
            "address_2": "Ste 100",
            "address_purpose": "LOCATION",
            "city": "Milledgeville",
            "state": "GA",
            "postal_code": "310617108",
            "country_code": "US",
            "telephone_number": "706-650-0061",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6061 Lake Oconee Pkwy",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "GA",
            "postal_code": "306423798",
            "country_code": "US",
            "telephone_number": "706-650-0061",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTHEAST RETINA CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-14",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A",
        "authorized_official_last_name": "BECKER",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "470-243-2259"
    },
    "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": "GPA 668",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000293719A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000605283B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• South Augusta Dialysis Clinic LLC
• South East Behavioral Community Services, Inc.
• South Path, P.C.
• Southeast Homecare & Respiratory Services
• Southeast Hospice, LLC,
• Southeastern Behavioral Health Services
• Southeastern Medical Brokers, Inc.
• Southern Anesthesia of Augusta LLC
• Southern Eye Clinic P.C.
• Southern Family Medical Center PC

• 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 Apr 28, 2026; 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.