Individual provider Active NPI

Maureen A Relland, MD

  • Ophthalmology Physician
  • New York, NY
National Provider Identifier
1972611242
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
095310 Issued in NY
Practice address
36 7TH Ave
Suite 506
New York, NY 10011-6609
Phone
(212) 645-7771
Fax
(212) 645-7356
NPI assigned
Aug 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 095310 NY Primary

Addresses

Primary practice location

36 7TH Ave
Suite 506
New York, NY 10011-6609

Mailing address

36 7TH Ave
Suite 506
New York, NY 10011-6609
Phone (212) 645-7771

Other identifiers 1

IdentifierTypeStateIssuer
157768MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070104000088 NY Practitioner - Ophthalmology 4284634833 Reassigns benefits to 1 organization
Practice locations: Brooklyn, NY; New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
New York Medical College, 1964
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

20 W 13TH St
New York, NY 10011-7995
Phone (212) 645-7771

460 Bay Ridge Pkwy
Brooklyn, NY 11209-2702
Phone (718) 833-2062

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
095310NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Amboy Medical Practice PC Ophthalmology CurrentSince Sep 1, 2024 Accepting new patients
Amboy Medical Practice PC CurrentSince Oct 1, 2009 Accepting new patients
Stephen Berch MD PC Ophthalmology Past Accepting new patients
Richmond University Medical Center Past Accepting new patients
St Vincents Hospital and Medical Center Past Accepting new patients

Locations

4434 Amboy Rd
Staten Island, NY 10312
Phone (718) 818-1015

275 Castleton Ave
Staten Island, NY 10301
Phone (718) 447-2829

355 Bard Ave
Staten Island, NY 10310
Phone (718) 818-1380

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972611242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 7TH AVE",
            "address_2": "SUITE 506",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100116609",
            "telephone_number": "212-645-7771",
            "fax_number": "212-645-7356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 7TH AVE",
            "address_2": "SUITE 506",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100116609",
            "telephone_number": "212-645-7771",
            "fax_number": "212-645-7356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RELLAND",
        "first_name": "MAUREEN",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "095310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "157768",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.