The Retina Clinic, LLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

MA1582492 Issued in NJ

Legal business name

THE RETINA CLINIC, LLC

Practice address

195 Route 46 West
Suite 204
Mine Hill, NJ 07803

Phone

(570) 604-3276

NPI assigned

Jun 1, 2007

Last updated

Aug 22, 2020By 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

Dr. Sachin Patel, MDNPI 1992886758

Title

Co Owner

Phone

(570) 604-3276

Specialties & licenses 1

Addresses

Other identifiers 2

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.

• Sachin B Patel, MD

  • Retina Specialist (Ophthalmology) Physician
  • Pottsville, PA
  • NPI 1992886758
  NPD (past) Authorized official

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972705085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 ROUTE 46 WEST",
            "address_2": "SUITE 204",
            "city": "MINE HILL",
            "state": "NJ",
            "postal_code": "07803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 ROUTE 46 WEST",
            "address_2": "SUITE 204",
            "city": "MINE HILL",
            "state": "NJ",
            "postal_code": "07803",
            "telephone_number": "570-604-3276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE RETINA CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "SACHIN",
        "authorized_official_title_or_position": "CO OWNER",
        "authorized_official_telephone_number": "570-604-3276",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NJ",
            "license": "MA1582492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. PATEL INDIVIDUAL NPI",
            "identifier": "1192886758",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1582492",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Soda, M.D.
• Jolene V. Stark, LPC
• Savitri Sundaram, M.D.
• Subramoni Sundaram, M.D.
• Karla Anne Baxter Tabobo, RN
• Three Danes Wellness
• True Impact Physical Therapy & Sports Rehabilitation
• Chelsey Walilko, CCC-SLP

• Ophthalmology Physician in Mine Hill, NJ
• Providers in Mine Hill, NJ by specialty
• Ophthalmology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.