Mid-Hudson Ophthalmological Retina Consultants, PLLC

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

License

149190 Issued in NY

Legal business name

MID-HUDSON OPHTHALMOLOGICAL RETINA CONSULTANTS, PLLC

Practice address

450 Gidney Ave
Newburgh, NY 12550-3116

Phone

(845) 562-1100

Fax

(845) 562-1162

NPI assigned

Nov 29, 2006

Organization subpart

No

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

Authorized official

Name

Colleen M Locicero

Title

Office Manager

Phone

(845) 692-0834

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• MID-HUDSON RETINA CONSULTANTS, PLLC Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 4

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

• Glenn J Green, M.D.

  • Ophthalmology Physician
  • Newburgh, NY
  • NPI 1912994328
  Medicare reassignment Care Compare group NPD
• Larry Koreen, MD, PHD, MPH

  • Ophthalmology Physician
  • Newburgh, NY
  • NPI 1619174554
  Medicare reassignment Care Compare group NPD
• Dov B Sebrow, MD

  • Retina Specialist (Ophthalmology) Physician
  • Newburgh, NY
  • NPI 1639436462
  Medicare reassignment Care Compare group NPD
• Adam M Katz, M.D.

  • Ophthalmology Physician
  • Vero Beach, FL
  • NPI 1790772101
  NPD (past)

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491177600000",
    "number": "1831266493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 GIDNEY AVE",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125503116",
            "telephone_number": "845-562-1100",
            "fax_number": "845-562-1162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 GIDNEY AVE",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125503116",
            "telephone_number": "845-562-1100",
            "fax_number": "845-562-1162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-HUDSON OPHTHALMOLOGICAL RETINA CONSULTANTS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2017-04-03",
        "status": "A",
        "authorized_official_last_name": "LOCICERO",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "845-692-0834"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "NY",
            "license": "149190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "192875-2",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "149190-1",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00718525",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MID-HUDSON RETINA CONSULTANTS, PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mid Hudson Physical Medicine & Rehabilitation PC
• Mid Hudson Surgical Associates, PC
• Mid Valley Oncology Hematology, P.C.
• Mid-Hudson Anesthesiologists, PC.
• Mid-Hudson Managed Home Care, Inc.
• Mid-Hudson Urological Associates
• Alexa Justine Mignone
• Mike Garda LMHC
• Matthew Mikesh, P.T.
• Joy Noelle Miladinovich, COTA/L

• Retina Specialist (Ophthalmology) Physician in Newburgh, NY
• Providers in Newburgh, NY by specialty
• Retina Specialist (Ophthalmology) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2017; 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.