Retina Consultants of Orange County, a Medical Corporation

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

License

G32479 Issued in CA

Legal business name

RETINA CONSULTANTS OF ORANGE COUNTY, A MEDICAL CORPORATION

Practice address

301 W Bastanchury Rd
285
Fullerton, CA 92835-3419

Phone

(714) 738-4620

Fax

(714) 738-0388

NPI assigned

May 25, 2006

Last updated

Mar 4, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Scott Grant, M.D.NPI 1194762310

Title

President

Phone

(714) 738-4620

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Interoperability endpoints

• Direct secure messaging: apirouz@rcoc.intellechartdirect.net
• Direct secure messaging: cng@rcoc.intellechartdirect.net
• Direct secure messaging: csuplee@rcoc.intellechartdirect.net
• Direct secure messaging: hramkumar@rcoc.intellechartdirect.net
• Direct secure messaging: ilee@rcoc.intellechartdirect.net
• Direct secure messaging: sadrean@rcoc.intellechartdirect.net
• Direct secure messaging: sgrant@rcoc.intellechartdirect.net

Practitioners 10

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.

• Scott Grant, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Fullerton, CA
  • NPI 1194762310
  Medicare reassignment Care Compare group NPD Authorized official
• Sean David Adrean, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Fullerton, CA
  • NPI 1073566568
  Medicare reassignment Care Compare group NPD
• Ivan Jisoo Lee, MD

  • Ophthalmology Physician
  • Fullerton, CA
  • NPI 1942769831
  Medicare reassignment Care Compare group NPD
• Ash Pirouz, MD

  • Retina Specialist (Ophthalmology) Physician
  • Fullerton, CA
  • NPI 1942489356
  Medicare reassignment Care Compare group NPD
• Hema Laskhmi Ramkumar, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Fullerton, CA
  • NPI 1184919524
  Medicare reassignment Care Compare group NPD
• Glen Daniel Jarus, MD

  • Retina Specialist (Ophthalmology) Physician
  • Whittier, CA
  • NPI 1619952306
  Medicare reassignment NPD
• Chang Sup Lee, MD

  • Ophthalmology Physician
  • Los Angeles, CA
  • NPI 1598296238

  Retina Specialist

  Medicare reassignment NPD
• Caleb NG

  • Retina Specialist (Ophthalmology) Physician
  • Upland, CA
  • NPI 1568842672
  Medicare reassignment NPD
• Zackery Oakey, MD

  • Retina Specialist (Ophthalmology) Physician
  • Irvine, CA
  • NPI 1720320872
  Medicare reassignment NPD
• Gautam Vangipuram, M.D

  • Retina Specialist (Ophthalmology) Physician
  • Pasadena, CA
  • NPI 1780052233
  Medicare reassignment NPD

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646352000000",
    "number": "1770539702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 W BASTANCHURY RD",
            "address_2": "285",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353419",
            "telephone_number": "714-738-4620",
            "fax_number": "714-738-0388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 W BASTANCHURY RD",
            "address_2": "285",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353419",
            "telephone_number": "714-738-4620",
            "fax_number": "714-738-0388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RETINA CONSULTANTS OF ORANGE COUNTY, A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2022-03-04",
        "certification_date": "2022-03-04",
        "status": "A",
        "authorized_official_last_name": "GRANT",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-738-4620",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "CA",
            "license": "G32479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deanna Resendiz
• Lilia Ivette Resendiz
• Tyler James Resler
• Restore Therapy Center
• Resurgence California, LLC
• Retina Institute of California Medical Group, a California Medical Par (Acuity Eye Group)
• Karen Sunga Revillosa
• Alex Reyes Ruiz
• Alberto Reyes
• Andrea Nicole Reyes

• Retina Specialist (Ophthalmology) Physician in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Retina Specialist (Ophthalmology) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2022; 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.