Organization Active NPI

Retina Consultants of Delmarva PA

  • Ophthalmology Physician
  • Salisbury, MD
National Provider Identifier
1972558971
Registry record updated Dec 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
RETINA CONSULTANTS OF DELMARVA PA
Practice address
6511 Deer Pointe Drive
Salisbury, MD 21804
Phone
(410) 546-8037
Fax
(410) 546-8038
NPI assigned
May 24, 2006
Last updated
Dec 11, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2017

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

Authorized official

Name
Lori Brown
Title
Office Manager
Phone
(410) 546-8037

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X NU Primary
Retina Specialist (Ophthalmology) Physician 207WX0107X NU

Addresses

Primary practice location

6511 Deer Pointe Drive
Salisbury, MD 21804

Mailing address

6511 Deer Pointe Dr
Salisbury, MD 21804-1667
Phone (410) 546-8037

Other identifiers 2

IdentifierTypeStateIssuer
0000666302MedicaidDE
149351500MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DE2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050119000340 MD Part B Supplier - Clinic/Group Practice 3375592132 Receives reassigned benefits from 4 practitioners
Practice locations: Easton, MD; Salisbury, MD
O20120521000271 DE Part B Supplier - Clinic/Group Practice 3375592132 Receives reassigned benefits from 4 practitioners
Practice locations: Dover, DE; Milford, DE

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
21D2323086Retina Consultants of Delmarva6511 Deer Pointe Drive, Salisbury, MD 21804Certificate of waiverApr 30, 2027

National Provider Directory

National Provider Directory

Locations

1380 S State St
Dover, DE 19901
Phone (302) 674-8000

28417 DuPont Blvd
Millsboro, DE 19966
Phone (410) 546-8037

28322 Lewes Georgetown Hwy
Milton, DE 19968
Phone (302) 684-2020

8191 Ocean Gtwy
Easton, MD 21601
Phone (443) 849-2106

6511 Deer Pointe Dr
Salisbury, MD 21804
Phone (410) 546-8037

Interoperability endpoints

  • Direct secure messaging: tpeck@rcdelmarva.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512950400000",
    "number": "1972558971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6511 DEER POINTE DR",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218041667",
            "telephone_number": "410-546-8037",
            "fax_number": "410-546-8038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6511 DEER POINTE DRIVE",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "21804",
            "telephone_number": "410-546-8037",
            "fax_number": "410-546-8038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RETINA CONSULTANTS OF DELMARVA PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2017-12-11",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "410-546-8037"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000666302",
            "state": "DE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149351500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.