Organization Active NPI

Retina Consultants Inc

  • Retina Specialist (Ophthalmology) Physician
  • Providence, RI
National Provider Identifier
1780765354
Registry record updated Jul 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
Legal business name
RETINA CONSULTANTS INC
Practice address
101 Plain St Ste 101
Providence, RI 02903-4828
Phone
(401) 274-5844
Fax
(401) 274-9462
NPI assigned
Oct 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2020

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

Authorized official

Name
Edwina L Rego
Title
Manager
Phone
(401) 274-5844

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X
Retina Specialist (Ophthalmology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207WX0107X Primary

Addresses

Primary practice location

101 Plain St Ste 101
Providence, RI 02903-4828

Mailing address

101 Plain St Ste 101
Providence, RI 02903-4828
Phone (401) 274-5844

Other identifiers 2

IdentifierTypeStateIssuer
9729321MedicaidMA
RC01092MedicaidRI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address apani@rcri.intellechartdirect.net Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, RI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060215000506 MA Part B Supplier - Clinic/Group Practice 0749295525 Receives reassigned benefits from 2 practitioners
Practice locations: Swansea, MA
O20091015000191 RI Part B Supplier - Clinic/Group Practice 0749295525 Receives reassigned benefits from 2 practitioners
Practice locations: Cumberland, RI; North Kingstown, RI; Providence, RI

National Provider Directory

National Provider Directory

Locations

888 Maple St
Fall River, MA 02720
Phone (508) 673-9552

175 Nate Whipple Hwy
Ste 107
Cumberland, RI 02864
Phone (401) 333-0680

1130 Rod Rd
#F104
North Kingstown, RI 02852
Phone (401) 274-5844

1130 Ten Rod Rd
Ste F104
North Kingstown, RI 02852
Phone (401) 274-5844

101 Plain St
Ste 101
Providence, RI 02903
Phone (401) 274-5844

Interoperability endpoints

  • Direct secure messaging: apani@rcri.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595289600000",
    "number": "1780765354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 PLAIN ST STE 101",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034828",
            "telephone_number": "401-274-5844",
            "fax_number": "401-274-9462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PLAIN ST STE 101",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034828",
            "telephone_number": "401-274-5844",
            "fax_number": "401-274-9462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RETINA CONSULTANTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A",
        "authorized_official_last_name": "REGO",
        "authorized_official_first_name": "EDWINA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "401-274-5844"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology, Retina Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9729321",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RC01092",
            "state": "RI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "apani@rcri.intellechartdirect.net",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "101 Plain St Ste 101",
            "city": "Providence",
            "state": "RI",
            "country_code": "US",
            "postal_code": "029034828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2020; 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.