Retina Specialists of Minnesota PLLC

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

Legal business name

RETINA SPECIALISTS OF MINNESOTA PLLC

Practice address

3525 Plymouth Blvd Ste 207
Plymouth, MN 55447-1384

Phone

(617) 407-2304

NPI assigned

Apr 21, 2026

Last updated

Apr 21, 2026By 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

Sandra R Montezuma, MDNPI 1285798470

Title

Physician Owner

Phone

(617) 407-2304

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 1

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.

• Sandra Rocio Montezuma, M.D.

  • Ophthalmology Physician
  • Plymouth, MN
  • NPI 1285798470
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1776729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776729600000",
    "number": "1841135340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3525 PLYMOUTH BLVD STE 207",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554471384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 PLYMOUTH BLVD STE 207",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554471384",
            "telephone_number": "617-407-2304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RETINA SPECIALISTS OF MINNESOTA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-21",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A",
        "authorized_official_last_name": "MONTEZUMA",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "617-407-2304",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology, Retina Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Melody Joy Richards, MA, LPC

• Retina Specialist (Ophthalmology) Physician in Plymouth, MN
• Providers in Plymouth, MN by specialty
• Retina Specialist (Ophthalmology) Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2026; 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.