RETINA & VITREOUS CONSULTANTS OF WI, LTD. (NPI# 1114044435) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114044435 |
| Entity Type | Organization |
| Organization Name | RETINA & VITREOUS CONSULTANTS OF WI, LTD. |
| Practice Address |
2600 N Mayfair Rd Suite 901 Milwaukee WI 53226-1309 |
| Practice Telephone | 4147743484 |
| Practice Fax Number | 4147783445 |
| Mailing Telephone | 4147743484 |
| Mailing Fax Number | 4147783445 |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2020-10-16 |
| Authorized Official Name | SHARATH C RAJA (PRESIDENT) |
| Authorized Official Telephone | 4147743484 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207W00000X | Ophthalmology | Allopathic & Osteopathic Physicians | ||
| Y | 207WX0107X |
Ophthalmology Specialization: Retina Specialist |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 32708400 | 05 |
| Street Address |
2600 N MAYFAIR RD SUITE 901 |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53226-1309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093710741 | Frederick H Reeser | Ophthalmology | 2600 N Mayfair Rd, Ste 901, Milwaukee, WI 53226-1307 | 2005-06-18 |
| 1770023970 | Tarah Randazzo | Counselor | 2600 N Mayfair Rd, Suite 650, Milwaukee, WI 53226-1309 | 2017-03-07 |
| 1083971725 | Forefront Dermatology, S.c. | Dermatology | 2600 N Mayfair Rd, Mayfair North Tower, Suite 810, Milwaukee, WI 53226 | 2012-04-19 |
| 1538308689 | Erin Mcginty | Counselor | 2600 N Mayfair Rd, Suite 650, Milwaukee, WI 53226-1309 | 2009-02-12 |
| 1770748303 | Erik Alexander | Dermatology | 2600 N Mayfair Rd, Suite 810, Milwaukee, WI 53226-1309 | 2008-07-23 |
| 1366634685 | Terry Carr | Social Worker | 2600 N Mayfair Rd, Suite 850, Milwaukee, WI 53226-1309 | 2007-08-10 |
| 1174748628 | Parkland Clinic-muni H Patel Md Sc | Clinic/Center | 2600 N Mayfair Rd, Ste 850, Milwaukee, WI 53226-1309 | 2007-04-17 |
| 1558482364 | Drs. Massaro & Kalenak S C | Ophthalmology | 2600 N Mayfair Rd, Milwaukee, WI 53226-1309 | 2007-04-02 |
| 1598811135 | Cynthia S Bujanovich | Registered Nurse | 2600 N Mayfair Rd, Suite 901, Milwaukee, WI 53226-1309 | 2007-01-26 |
| 1306992870 | Tracie L Gurda | Specialist/Technologist, Other | 2600 N Mayfair Rd, Suite 901, Milwaukee, WI 53226-1309 | 2007-01-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912511155 | Alexander Harlan | Pharmacist | 900 N 92nd St, Milwaukee, WI 53226 | 2020-09-04 |
| 1558985762 | Armghan Haider Ans | Student in an Organized Health Care Education/Training Program | 9200 W. Wisconsin Ave. Froedtert Hospital & Medical Col, Milwaukee, WI 53226 | 2020-06-03 |
| 1669001103 | Kimberly Tyler | Student in an Organized Health Care Education/Training Program | 8701 W Watertown Plank Road, Medical College of Wisconsin Dept of Internal Medicine, Wauwatosa, WI 53226 | 2020-04-06 |
| 1972131993 | Francesca Meloy Devine | Student in an Organized Health Care Education/Training Program | Medical Education Office: Children's Corporate Center, 999 N. 92nd St., Suite 730, Milwaukee, WI 53226 | 2020-03-27 |
| 1285275248 | Sharitta Alford | Technician | 12250 West North Avenue, Apartment 142b, Wauwatosa, WI 53226 | 2019-10-01 |
| 1619528023 | Linda Marie Sabatinelli | Technician | 12107 W. Woodland Ave, Wauwatosa, WI 53226 | 2019-09-26 |
| 1598310195 | Matthew Laviolette | Surgery | Medical College of Wisconsin, 8701 Watertown Plank Rd., Surgical Oncology, Milwaukee, WI 53226 | 2019-08-09 |
| 1962056432 | Lyndsey Marie Bratberg | Physician Assistant | F&mcw Clinical Cancer Center 9200 W. Wisconsin Ave., Milwaukee, WI 53226 | 2019-08-01 |
| 1659832855 | Benjamin David Seadler | Surgery | Mcw, Department of Surgery, 8701 Watertown Plank Road, Milwaukee, WI 53226 | 2019-03-29 |
| 1861953267 | Michael Dryden | Student in an Organized Health Care Education/Training Program | 8701 Watertown Plank Rd., Milwaukee, WI 53226 | 2019-03-27 |
| Find all providers in zip 53226 | ||||
| Taxonomy Code | 207WX0107X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| Specialization | Retina Specialist |
| An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases. |
| Notes: Source: American Society of Retina Specialists, www.asrs.org [1/1/2017: new] - Additional Resources: American Academy of Ophthalmology, www.aao.org. Macula Society, www.maculasociety.org. Retina Society, www.retinasociety.org. Association of University Professors of Ophthalmology, www.aupo.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811253289 | Michael Edward Possin | Ophthalmology | 200 Theda Clark Medical Plz Ste 110, Neenah, WI 54956-2790 | 2012-04-10 |
| 1437164175 | Northeast Wisconsin Retina Associates Sc | Ophthalmology | 200 Theda Clark Plaza, Suite 110, Neenah, WI 54956-2790 | 2006-07-30 |
| 1700819281 | Rajeev Buddi | Ophthalmology | 200 Theda Clark Pl, Suite 110, Neenah, WI 54956 | 2006-07-08 |
| 1356640726 | Khalid S Kahook | Ophthalmology | 200 Theda Clark Plaza, Suite 110, Neenah, WI 54956-2790 | 2011-03-24 |
| 1679580070 | John P Rosculet | Ophthalmology | 200 Theda Clark Plaza, Suite 110, Neenah, WI 54956 | 2006-08-01 |
| 1922013671 | Charles Hejny | Ophthalmology | 200 Theda Clark Plaza, Suite 110, Neenah, WI 54956 | 2006-07-30 |
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| 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.