Retina Center PC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

R9531 Issued in MO

Legal business name

RETINA CENTER PC

Practice address

11710 Old Ballas Rd
Suite 102
Saint Louis, MO 63141-7076

Phone

(314) 569-2020

Fax

(314) 569-1596

NPI assigned

Jan 31, 2007

Last updated

Jan 24, 2024By 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

Kimberly Ann Thompson

Title

Administrator

Phone

(314) 569-2020

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 7

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.

• Levent Akduman, MD

  • Ophthalmology Physician
  • Saint Louis, MO
  • NPI 1245344605
  Medicare reassignment Care Compare group
• Robert Joseph Olk, MD

  • Ophthalmology Physician
  • Saint Louis, MO
  • NPI 1265429245
  Medicare reassignment Care Compare group
• Shana Widick Rose, M.D.

  • Ophthalmology Physician
  • Fenton, MO
  • NPI 1508020645
  Medicare reassignment
• Enrique Peralta

  • Ophthalmology Physician
  • Swansea, IL
  • NPI 1346237534

  MO

  Medicare reassignment
• John Galanis

  • Ophthalmology Physician
  • Saint Louis, MO
  • NPI 1215921069
  NPD
• John Arthur McGreal Jr., OD

  • Optometrist
  • Saint Louis, MO
  • NPI 1689661886
  NPD
• Steven F Lee, MD

  • Ophthalmology Physician
  • Saint Louis, MO
  • NPI 1134118482
  NPD (past)

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706054400000",
    "number": "1861539694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11710 OLD BALLAS RD",
            "address_2": "SUITE 102",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631417076",
            "telephone_number": "314-569-2020",
            "fax_number": "314-569-1596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11710 OLD BALLAS RD",
            "address_2": "SUITE 102",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631417076",
            "telephone_number": "314-569-2020",
            "fax_number": "314-569-1596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RETINA CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-11",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "314-569-2020"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MO",
            "license": "R9531",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MO",
            "license": "2004012770",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Retina & Vitreous Consultants Inc
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• Andrea R Reubin, MSW
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• James M Reusch, M.D.
• Adrianna Ralynne Reuss, RN

• Ophthalmology Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Ophthalmology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2024; 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.