RETINA & VITREOUS L L C (NPI# 1093999609) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093999609 |
| Entity Type | Organization |
| Organization Name | RETINA & VITREOUS L L C |
| Practice Address |
53822 Generations Drive South Bend IN 46635-1543 |
| Practice Telephone | 5742333711 |
| Practice Fax Number | 5742881702 |
| Mailing Telephone | 5742333711 |
| Mailing Fax Number | 5742881702 |
| Enumeration Date | 2007-12-19 |
| Last Update Date | 2017-07-12 |
| Authorized Official Name | ROBERT T LEE (PARTNER) |
| Authorized Official Telephone | 5742333711 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207WX0107X |
Ophthalmology Specialization: Retina Specialist |
Allopathic & Osteopathic Physicians | ||
| Y | 207W00000X | Ophthalmology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200883090 | 05 | |
| IN | ANTHEM | 000000549277 | 01 |
| Street Address |
53822 GENERATIONS DRIVE |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46635-1543 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295078228 | Michael Pfeiffer | Otolaryngology | 6301 University Commons Ste 360, South Bend, IN 46635 | 2013-03-27 |
| 1679833438 | Whitney Moore | Physical Therapy Assistant | 2012 Ironwood Circle, Suite 230, Circle Centre Building, South Bend, IN 46635 | 2012-05-25 |
| 1992917637 | Elly May Wynia | Social Worker | 53700 Generations Drive, Suite 200, South Bend, IN 46635 | 2007-05-04 |
| 1891917282 | Lifetime Dental Careof Indiana, PC | Dentist | 1605 North Ironwood, South Bend, IN 46635 | 2007-05-03 |
| 1750502878 | Tyrone Arteese Armstead | Pharmacist | 3355 Douglas Rd, South Bend, IN 46635 | 2007-05-02 |
| 1013033794 | Bradley Richard Swanson | Dentist | 54505 26th Street, Unit E, South Bend, IN 46635 | 2007-03-22 |
| 1225185739 | Michael J. O'connell D.o. Inc | Family Medicine | 17960 Cleveland Road, South Bend, IN 46635 | 2007-01-05 |
| 1346300365 | Chad Fulton Harrington | Dentist | 3340 Douglas Rd., South Bend, IN 46635 | 2006-12-11 |
| 1346313236 | Dr Shawn R Long Dds PC | Dentist | 16329 State Rd 23, South Bend, IN 46635 | 2006-11-16 |
| 1134206576 | Kearn David Hinchman | Psychiatry & Neurology | 53779 Generations Drive, Suite 1, South Bend, IN 46635 | 2006-11-01 |
| Find all providers in zip 46635 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467585323 | Gabriele Eye Institute | Ophthalmology | 2042 E Ireland Rd, South Bend, IN 46614-2909 | 2007-03-13 |
| 1417992199 | Eric Younghee Yoon | Ophthalmology | 707 North Michigan Street, Suite 210, South Bend, IN 46601-1069 | 2006-06-18 |
| 1497730261 | Bruce H Schwartz | Ophthalmology | 707 N Michigan St Ste 210, South Bend, IN 46601-1069 | 2005-12-14 |
| 1023017902 | Thomas L Hauch | Ophthalmology | 53822 Generations Dr, South Bend, IN 46635-1543 | 2005-07-21 |
| 1548304876 | Advanced Ophthalmology of Michiana LLC | Ophthalmology | 707 N Michigan St, Ste 210, South Bend, IN 46601-1067 | 2007-02-19 |
| 1033163894 | Ersalan A Rahman | Ophthalmology | 211 N Eddy St, South Bend, IN 46617-2808 | 2006-05-19 |
| 1073598835 | Steve L Gerber | Ophthalmology | 707 N Michigan St, Ste 210, South Bend, IN 46601-1067 | 2005-12-14 |
| 1184614638 | Susan E Park | Ophthalmology | 211 N Eddy St, South Bend, IN 46617-2808 | 2005-10-26 |
| 1952391526 | Martyn A Wills | Ophthalmology | 211 N Eddy St, South Bend, IN 46617-2808 | 2005-10-25 |
| 1962401869 | Robert Lee | Ophthalmology | 53822 Generations Dr, South Bend, IN 46635-1543 | 2005-07-21 |
| Find all providers in SOUTH BEND | ||||
| City | SOUTH BEND |
| Zip Code | 46635 |
Please comment or provide details below to improve the information on RETINA & VITREOUS L L C.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.