RETINA & VITREOUS L L C
NPI 1093999609
Ophthalmology in South Bend, IN

Q: What is Retina & Vitreous L L C's NPI number?

The NPI number for Retina & Vitreous L L C is 1093999609. It was assigned to this organization in the NPPES registry on December 19, 2007.

Q: What is Retina & Vitreous L L C's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Active since December 19, 2007

53822 GENERATIONS DRIVE, SOUTH BEND, IN 46635(574) 233-3711(574) 288-1702 Get Directions Write a Review

NPPES record last updated: July 12, 2017. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Retina & Vitreous L L C NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RETINA & VITREOUS L L C (NPI 1093999609) is a healthcare organization registered as an ophthalmology in South Bend, Indiana and active in the NPI registry since December 2007. The organization lists Robert T Lee, Partner, as its authorized official.

NPPES Registry Identity

NPI1093999609

Entity TypeOrganization

Primary Taxonomy207W00000X

Legal Business NameRETINA & VITREOUS L L C

Location Address53822 GENERATIONS DRIVESouth Bend, IN 46635-1543

Mailing Address53822 Generations DriveSouth Bend, IN 46635-1543 · (574) 233-3711 · Fax (574) 288-1702

Phone(574) 233-3711

Fax(574) 288-1702

Organization SubpartNo

Authorized OfficialRobert T LeePartner · (574) 233-3711

Enumeration DateDecember 19, 2007

Last NPPES UpdateJuly 12, 2017

✔ NPI 1093999609 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians

Taxonomy Code207W00000X

Definition

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.

Also ListedOphthalmology · Retina SpecialistTaxonomy 207WX0107X

53822 GENERATIONS DRIVE, South Bend, IN 46635

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Other Identifiers 3

Medicaid200883090IN

Other000000549277IN · Anthem

Medicare PIN255360IN

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Retina & Vitreous L L C is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by March 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date

StateIndianaEnrollment IDO20080219000467Non-DME Part B · Clinic/Group PracticeDue dateMarch 31, 2027

Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Retina & Vitreous L L C, which bills Medicare for the services this clinician delivers.

Clinician (1)

Robert Lee, MD

Ophthalmology

NPI 1962401869

53822 GENERATIONS DR
South Bend, IN 46635

(574) 233-3711

✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Retina & Vitreous L L C's NPI number?

The NPI number for Retina & Vitreous L L C is 1093999609. It was assigned to this organization in the NPPES registry on December 19, 2007.

Where is Retina & Vitreous L L C located?

Retina & Vitreous L L C is located at 53822 Generations Drive, South Bend, IN 46635. The listed phone number is (574) 233-3711.

What is Retina & Vitreous L L C's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Retina & Vitreous L L C enrolled in Medicare?

Yes. Retina & Vitreous L L C is registered in the Medicare PECOS enrollment system.

When is Retina & Vitreous L L C's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Indiana, Clinic/Group Practice) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Retina & Vitreous L L C?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Ophthalmology) reassigns their Medicare billing to Retina & Vitreous L L C. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Retina & Vitreous L L C accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and Anthem Blue Cross and Blue Shield list Retina & Vitreous L L C as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Retina & Vitreous L L C was last updated on July 12, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.