Retina Institute, P.C.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

50003889A Issued in IN

Legal business name

RETINA INSTITUTE, P.C.

Practice address

9002 N Meridian St Ste 102
Indianapolis, IN 46260-5349

Phone

(317) 573-4410

Fax

(317) 573-4412

NPI assigned

Jul 28, 2006

Last updated

Nov 14, 2007By 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

Sang H KimNPI 1033119417

Title

Office Manager

Phone

(317) 573-4410

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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.

• Sang Hoon Kim, M.D.

  • Ophthalmology Physician
  • Indianapolis, IN
  • NPI 1033119417
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194998400000",
    "number": "1912911827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9002 N MERIDIAN ST STE 102",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462605349",
            "telephone_number": "317-573-4410",
            "fax_number": "317-573-4412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9002 N MERIDIAN ST STE 102",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462605349",
            "telephone_number": "317-573-4410",
            "fax_number": "317-573-4412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RETINA INSTITUTE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-11-14",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "SANG",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "317-573-4410"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IN",
            "license": "50003889A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Ophthalmology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2007; 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.