RETINA CENTER OF MAINE, LLC PA (NPI# 1801077128) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801077128 |
| Entity Type | Organization |
| Organization Name | RETINA CENTER OF MAINE, LLC PA |
| Practice Address |
195 Fore River Pkwy Ste 480 Portland ME 04102-2787 |
| Practice Telephone | 2077733937 |
| Practice Fax Number | 2077730801 |
| Mailing Telephone | 2077733937 |
| Mailing Fax Number | 2077730801 |
| Enumeration Date | 2007-11-15 |
| Last Update Date | 2017-04-18 |
| Authorized Official Name | DR. MARK WILSON BALLES (MD / PRACTICE OWNER) |
| Authorized Official Telephone | 2077733937 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207WX0107X |
Ophthalmology Specialization: Retina Specialist |
MD14047 | ME | Allopathic & Osteopathic Physicians |
| Street Address |
195 FORE RIVER PKWY STE 480 |
| City | PORTLAND |
| State | ME |
| Zip Code | 04102-2787 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780654392 | Mark W Balles | Ophthalmology | 195 Fore River Pkwy Ste 480, Portland, ME 04102-2787 | 2006-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720602964 | Ci Yen Joanna Man | Student in an Organized Health Care Education/Training Program | 190 Park Ave., Portland, ME 04102 | 2020-06-03 |
| 1841811338 | Abby Zarotny Sahagian | Nurse Anesthetist, Certified Registered | Mmc Anesthesia and Perioperative Medicine, 22 Bramhall St, Portland, ME 04102 | 2020-05-06 |
| 1124656863 | Zachary Bernard Tillett | Student in an Organized Health Care Education/Training Program | Maine Medical Center 22 Bramhall St., Portland, ME 04102 | 2020-03-30 |
| 1215564323 | Joshua Allen Swenson | Student in an Organized Health Care Education/Training Program | 33 Bramhall St, Portland, ME 04102 | 2020-03-26 |
| 1740776434 | Rishi Phakey | Dentist | Community Dental, 190 Park Ave, Portland, ME 04102 | 2018-07-05 |
| 1982192571 | Jessica Thomas | Doula | 619 Brighton Ave #101, Rosemont Wellness Center, Portland, ME 04102 | 2018-04-29 |
| 1699270744 | Shane D Kirkegaard | Student in an Organized Health Care Education/Training Program | Maine Medical Center 22 Bramhall Street, Portland, ME 04102 | 2018-03-29 |
| 1144752494 | Al-shawk Home Healthcare, LLC | Technician | 640 Brighton Ave Ste 8, Portland, ME 04102 | 2017-03-28 |
| 1376074674 | Samuel B Potter | Emergency Medicine | Maine Medical Center, 22 Bramhall Street, Portland, ME 04102 | 2017-03-27 |
| 1043767536 | Kevin De Ruiter | Social Worker | 129 Pine St Apt 6, Portland, ME 04102 | 2016-09-01 |
| Find all providers in zip 04102 | ||||
| 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 |
|---|---|---|---|---|
| 1477071926 | Nelsi Inc | Ophthalmology | 11786 Sw Barnes Rd Ste 270, Portland, OR 97225-5929 | 2017-09-05 |
| 1093722258 | Brandon Lujan | Ophthalmology | 3375 Sw Terwilliger Blvd, Portland, OR 97239-4146 | 2006-08-01 |
| 1265485890 | Andreas K Lauer | Ophthalmology | 3375 Sw Terwilliger Blvd, Portland, OR 97239-4146 | 2006-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447868674 | Sylvan Retina LLC | Ophthalmology | 35 Eastward Lane, #4- Suite A, Ellsworth, ME 04605-1744 | 2020-07-14 |
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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.