Ridley Creek Retina LLC
NPI 1417564592 · Ophthalmology Physician · Media, PA
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Ridley Creek Retina LLC is a Ophthalmology Physician organization in Media, PA (NPI 1417564592).
Provider details
- NPI number
- 1417564592
- Entity type
- Organization
- Primary specialty
- Ophthalmology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jason Lange, President(610) 892-1708
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Internal Medicine Physician207R00000X
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 6532 Bayshore BlvdTampa, FL 33611-5505Phone: (610) 892-1708Fax: (610) 892-8766
Registry dates
- Enumerated
- 2020-09-23
- Last updated
- 2025-12-23
- Certified
- 2025-12-23
Frequently asked questions
- What is Ridley Creek Retina LLC's NPI number?
- Ridley Creek Retina LLC's National Provider Identifier (NPI) is 1417564592, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Ridley Creek Retina LLC?
- Ridley Creek Retina LLC is classified in the NPPES registry as Ophthalmology Physician (Allopathic & Osteopathic Physicians).
- Where is Ridley Creek Retina LLC located?
- Ridley Creek Retina LLC's practice location on file with NPPES is 200 E State St Ste 303, Media, PA 19063-3434.
- What is Ridley Creek Retina LLC's phone number?
- The practice phone number listed in the NPPES registry for Ridley Creek Retina LLC is (610) 892-1708.
- Does Ridley Creek Retina LLC accept Medicare?
- Ridley Creek Retina LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Ridley Creek Retina LLC?
- The authorized official listed on Ridley Creek Retina LLC's NPPES record is Jason Lange, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Ridley Creek Retina LLC's NPI active?
- Yes — Ridley Creek Retina LLC's NPI (1417564592) is active in the NPPES registry as of the last update on 2025-12-23.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.