Active NPI
Retina Vitreous Center, PLLC
- Retina Specialist (Ophthalmology) Physician
- Edmond, OK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Retina Specialist (Ophthalmology) Physician
- Legal business name
- RETINA VITREOUS CENTER, PLLC
- Practice address
- 1851 S Kelly Ave Ste a
Edmond, OK 73013-3929 - Phone
- (405) 607-6699
- Fax
- (405) 607-6685
- NPI assigned
- Jul 10, 2011
- Last updated
- Sep 30, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Sandeep N. Shah, M.D.
- Title
- Founding Manager
- Phone
- (405) 607-6699
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | |||
| Retina Specialist (Ophthalmology) Physician | 207WX0107X | Primary |
Addresses
Primary practice location
1851 S Kelly Ave Ste a
Edmond, OK 73013-3929
Mailing address
PO Box 410108
Kansas City, MO 64141-0108
Phone (405) 607-6699
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 37D2106972 | Retina Vitreous Center | Certificate of waiver | Jan 3, 2028 |
National Provider Directory
National Provider DirectoryLocations
1851 S Kelly Ave
Edmond, OK 73013
1851 S Kelly Ave
Ste A
Edmond, OK 73013
Phone (405) 607-6699
920 NW 139th Street Pkwy
Edmond, OK 73013
1455 S Douglas Blvd
Ste A
Midwest City, OK 73130
Phone (405) 607-6699
1125 N Porter Ave
Ste 100
Norman, OK 73071
Phone (405) 360-6736
716 24th Ave NW
Norman, OK 73069
1455 S Douglas Blvd
Oklahoma City, OK 73130
Phone (405) 733-4545
721 NW 6th St
Fl 2
Oklahoma City, OK 73102
Phone (405) 271-7000
Interoperability endpoints
- dgrasic@rvcoklahoma.intellechartdirect.net
- sastani@rvcoklahoma.intellechartdirect.net
Practitioners & affiliated clinicians
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.
-
- Retina Specialist (Ophthalmology) Physician
- Edmond, OK
- NPI 1154362770
-
- Optometrist
- Edmond, OK
- NPI 1174142418
-
- Retina Specialist (Ophthalmology) Physician
- Edmond, OK
- NPI 1003542101
-
- Retina Specialist (Ophthalmology) Physician
- Edmond, OK
- NPI 1982256558
-
- Retina Specialist (Ophthalmology) Physician
- Edmond, OK
- NPI 1386932333
-
- Retina Specialist (Ophthalmology) Physician
- Edmond, OK
- NPI 1689866576
-
- Retina Specialist (Ophthalmology) Physician
- Edmond, OK
- NPI 1780634782
-
- Gerontology Nurse Practitioner
- Edmond, OK
- NPI 1225673122
-
- Internal Medicine Physician
- Oklahoma City, OK
- NPI 1376535328
-
- Optometrist
- Elk City, OK
- NPI 1083067508
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310256000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1790726400000",
"number": "1811284946",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 410108",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641410108",
"telephone_number": "405-607-6699",
"fax_number": "405-607-6685"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1851 S KELLY AVE STE A",
"city": "EDMOND",
"state": "OK",
"postal_code": "730133929",
"telephone_number": "405-607-6699",
"fax_number": "405-607-6685"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RETINA VITREOUS CENTER, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2011-07-10",
"last_updated": "2026-09-30",
"certification_date": "2026-09-30",
"status": "A",
"authorized_official_last_name": "SHAH",
"authorized_official_first_name": "SANDEEP",
"authorized_official_middle_name": "N.",
"authorized_official_title_or_position": "FOUNDING MANAGER",
"authorized_official_telephone_number": "405-607-6699",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Optometrist",
"state": null,
"license": null,
"primary": false
},
{
"code": "207WX0107X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Ophthalmology, Retina Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Edmond, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2026; 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.