Retina Specialists of Michigan PC

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

Legal business name

RETINA SPECIALISTS OF MICHIGAN PC

Practice address

5030 Cascade Rd SE
Grand Rapids, MI 49546-3725

Phone

(616) 954-2020

Fax

(616) 949-0408

NPI assigned

Oct 13, 2008

Last updated

Jun 6, 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

Heather Duhr

Title

Executive Director

Phone

(616) 466-7562

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Interoperability endpoints

• Direct secure messaging: aknapp@rsmi.intellechartdirect.net
• Direct secure messaging: aomari@rsmi.intellechartdirect.net
• Direct secure messaging: ekorot@rsmi.intellechartdirect.net
• Direct secure messaging: kdehorn@rsmi.intellechartdirect.net

Practitioners 19

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.

• Greg Bever, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Grand Rapids, MI
  • NPI 1114366440
  Medicare reassignment Care Compare group NPD
• Joseph Daniel Boss, M.D.

  • Uveitis and Ocular Inflammatory Disease (Ophthalmology) Physician
  • Grand Rapids, MI
  • NPI 1912346388
  Medicare reassignment Care Compare group NPD
• Kathleen Urban Dehorn, MD

  • Ophthalmology Physician
  • Grand Rapids, MI
  • NPI 1215143797
  Medicare reassignment Care Compare group NPD
• Austen Nicole Knapp, MD

  • Ophthalmology Physician
  • Grand Rapids, MI
  • NPI 1871098111
  Medicare reassignment Care Compare group NPD
• Edward Korot, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Grand Rapids, MI
  • NPI 1669853768
  Medicare reassignment Care Compare group NPD
• Amro Omari, MD

  • Ophthalmology Physician
  • Grand Rapids, MI
  • NPI 1922665587
  Medicare reassignment Care Compare group NPD
• Thomas Marshall Aaberg Jr., MD

  • Retina Specialist (Ophthalmology) Physician
  • Grand Rapids, MI
  • NPI 1194753186
  Medicare reassignment Care Compare group
• Nathan Francis Pezda, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Grand Rapids, MI
  • NPI 1669602033
  Medicare reassignment Care Compare group
• Liliya Shevchenko Sutherland, D.O.

  • Retina Specialist (Ophthalmology) Physician
  • Grand Rapids, MI
  • NPI 1942463252
  Medicare reassignment Care Compare group
• Scott James Westhouse, D.O.

  • Ophthalmology Physician
  • Grand Rapids, MI
  • NPI 1306016977
  Medicare reassignment Care Compare group
• Jordan Arthur Ueberroth, MD

  • Retina Specialist (Ophthalmology) Physician
  • Grand Rapids, MI
  • NPI 1558999821
  Medicare reassignment NPD
• Peter Henry Bast, M.D.

  • Ophthalmology Physician
  • Holland, MI
  • NPI 1295937332
  NPD (past)

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

{
    "created_epoch": "1223856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654473600000",
    "number": "1801048699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5030 CASCADE RD SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463725",
            "telephone_number": "616-954-2020",
            "fax_number": "616-949-0408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5030 CASCADE RD SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463725",
            "telephone_number": "616-954-2020",
            "fax_number": "616-949-0408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RETINA SPECIALISTS OF MICHIGAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-13",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A",
        "authorized_official_last_name": "DUHR",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "616-466-7562"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "4301077476",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology, Retina Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jhuan Ramon Resto Miranda, BT
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• Bruce Kevin Retterath, PH.D.
• Angie Ann Rettig
• Kristin Marie Rettig
• Karen Marie Reusch, PT

• Retina Specialist (Ophthalmology) Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Retina Specialist (Ophthalmology) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; 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.