Northeast Vitreo-Retinal Associates, P.C.

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

158307 Issued in NY

Legal business name

NORTHEAST VITREO-RETINAL ASSOCIATES, P.C.

Practice address

350 Northern Blvd
Suite 301
Albany, NY 12204-1000

Phone

(518) 465-1069

Fax

(518) 465-2420

NPI assigned

Oct 2, 2014

Last updated

Oct 2, 2014By 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

Mr. Michael G. Lambert, COT

Title

Office MGR./Technician

Phone

(518) 465-1069

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Center for Sight Other name

Tax ID family

Northeast Vitreo Retinal Assoc PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Northeast Vitreo Retinal Assoc PC

  • Ophthalmology Physician
  • Albany, NY
  • NPI 1093802597
  NPD tax ID

Practitioners 2

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.

• Jessica C Fleishman, MD

  • Ophthalmology Physician
  • Albany, NY
  • NPI 1669521845
  NPD (past)
• Howard Leon Tanenbaum, HOWARD TANENBAUM

  • Retina Specialist (Ophthalmology) Physician
  • Slingerlands, NY
  • NPI 1215956792
  NPD (past)

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

{
    "created_epoch": "1412208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412208000000",
    "number": "1952704199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 NORTHERN BLVD",
            "address_2": "SUITE 301",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122041000",
            "telephone_number": "518-465-1069",
            "fax_number": "518-465-2420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 NORTHERN BLVD",
            "address_2": "SUITE 301",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122041000",
            "telephone_number": "518-465-1069",
            "fax_number": "518-465-2420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST VITREO-RETINAL ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-02",
        "last_updated": "2014-10-02",
        "status": "A",
        "authorized_official_last_name": "LAMBERT",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "OFFICE MGR./TECHNICIAN",
        "authorized_official_telephone_number": "518-465-1069",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "COT"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NY",
            "license": "158307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00848706",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Center for Sight",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Medical Specialty Clinic/Center in Albany, NY
• Providers in Albany, NY by specialty
• Medical Specialty Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.