RETINA AND VITREOUS ASSOCIATES OF KENTUCKY PLLC NPI 1619949971

NPI Information

NPI: 1619949971
Provider Name: RETINA AND VITREOUS ASSOCIATES OF KENTUCKY PLLC

Doing Business As: RETINA ASSOCIATES OF KENTUCKY

Classification: Ophthalmology - 207WX0107X
Entity Type: Organization

Specialization: Retina Specialist

Address:
120 N EAGLE CREEK DR
STE 500
LEXINGTON, KY
ZIP 40509
Phone: (859) 263-3900
Get Directions

RETINA AND VITREOUS ASSOCIATES OF KENTUCKY PLLC is a retina specialist ophthalmology in Lexington, KY. The provider is an ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases. RETINA AND VITREOUS ASSOCIATES OF KENTUCKY PLLC NPI is 1619949971. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Retina Associates Of Kentucky.

The provider's business location address is:

120 N EAGLE CREEK DR
STE 500
LEXINGTON, KY
ZIP 40509-827
Phone: (859) 263-3900
Fax: (859) 263-3757

The provider's authorized official is Joseph Pravoot Gira .
The authorized official title is Owner and has the following contact phone number (314) 909-0633.

The CLIA number assigned to this NPI record is 18D1068560 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/2/2006 and was last updated on 10/11/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	152W00000X	Optometrist				No
2	152WL0500X	Optometrist	Low Vision Rehabilitation	1689DT	KENTUCKY	No
3	207W00000X	Ophthalmology			KENTUCKY	No
4	207WX0107X	Ophthalmology	Retina Specialist			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	7100871660	MEDICAID	KENTUCKY
2	0730481	MEDICAID	OHIO
3	7100856500	MEDICAID	KENTUCKY
4	0007018000	MEDICAID	WEST VIRGINIA
5	201209490A	MEDICAID	INDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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