NPIMap

Organization Active NPI

Retina Associates of Cleveland

  • Physician Assistant
  • Cleveland, OH
National Provider Identifier
1841697463
Registry record updated Nov 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.002593 Issued in OH
Legal business name
RETINA ASSOCIATES OF CLEVELAND
Practice address
15299 Bagley Rd Ste 200
Cleveland, OH 44130-4823
Phone
(440) 663-0022
NPI assigned
Nov 25, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2014

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

Authorized official

Name
Warren Laurita
Title
Administrator
Phone
(216) 831-4748

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X 50.002593 OH Primary

Addresses

Primary practice location

15299 Bagley Rd Ste 200
Cleveland, OH 44130-4823

Mailing address

3401 Enterprise Pkwy Ste 300
Beachwood, OH 44122-7340
Phone (216) 831-5700

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D1025187Retina Associates of Cleveland, Inc15299 East Bagley Road Suite 200, Middleburg Heights, OH 44130Certificate of waiverMay 2, 2028

National Provider Directory

National Provider Directory

Locations

15299 Bagley Rd
Ste 200
Middleburg Heights, OH 44130
Phone (440) 663-0022

Practitioners & affiliated clinicians

Practitioners 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1416873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416873600000",
    "number": "1841697463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 ENTERPRISE PKWY STE 300",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441227340",
            "telephone_number": "216-831-5700",
            "fax_number": "216-831-1959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15299 BAGLEY RD STE 200",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441304823",
            "telephone_number": "440-663-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RETINA ASSOCIATES OF CLEVELAND",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-25",
        "last_updated": "2014-11-25",
        "status": "A",
        "authorized_official_last_name": "LAURITA",
        "authorized_official_first_name": "WARREN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "216-831-4748"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.002593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.

Verify at the official NPI Registry.