RIDLEY CREEK RETINA LLC
NPI 1417564592
Ophthalmology in Media, PA

Q: What is Ridley Creek Retina LLC's NPI number?

The NPI number for Ridley Creek Retina LLC is 1417564592. It was assigned to this organization in the NPPES registry on September 23, 2020.

Q: What is Ridley Creek Retina LLC's specialty?

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

Active since September 23, 2020

200 E STATE ST STE 303, MEDIA, PA 19063(610) 892-1708(610) 892-8766 Get Directions Write a Review

NPPES record last updated: December 23, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 23, 2025, Sep 23, 2020 (2 updates tracked since 2020).

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About Ridley Creek Retina Llc NPPES

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

RIDLEY CREEK RETINA LLC (NPI 1417564592) is a healthcare organization registered as an ophthalmology in Media, Pennsylvania and active in the NPI registry since September 2020. The organization maintains a secondary practice location in Tampa and lists Jason Lange, President, as its authorized official.

NPPES Registry Identity

NPI1417564592

Entity TypeOrganization

Primary Taxonomy207W00000X

Legal Business NameRIDLEY CREEK RETINA LLC

Location Address200 E STATE ST STE 303Media, PA 19063-3434

Mailing Address200 E State St Ste 303Media, PA 19063-3434 · (610) 892-1708 · Fax (610) 892-8766

Phone(610) 892-1708

Fax(610) 892-8766

Organization SubpartNo

Authorized OfficialJason LangePresident · (610) 892-1708

Enumeration DateSeptember 23, 2020

Last NPPES UpdateDecember 23, 20252 updates tracked since enumeration

NPPES CertifiedDecember 23, 2025

✔ NPI 1417564592 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ 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 ListedInternal MedicineTaxonomy 207R00000X

Also ListedOphthalmology · Retina SpecialistTaxonomy 207WX0107X

Also ListedOphthalmology · Ophthalmic Plastic and Reconstructive SurgeryTaxonomy 207WX0200X

200 E STATE ST STE 303, Media, PA 19063

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Secondary Practice Location 1

Location 16532 Bayshore BlvdTampa, FL 33611-5505 · Phone (610) 892-1708 · Fax (610) 892-8766

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ridley Creek Retina Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 4 clinicians reassign Medicare billing to Ridley Creek Retina LLC, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (4)

Jason Lange, M.D.

Ophthalmology

NPI 1174937775

200 E STATE ST STE 105
Media, PA 19063

(610) 892-1708

✔ PECOS✔ Accepts Medicare0.4 mi

Andrea Saxon, M.D.

Ophthalmology

NPI 1538240700

8 MORTON AVE SUITE 101
Ridley Park, PA 19078

(610) 521-2111

✔ PECOS4.0 mi

Weiye Li, M.D.

Ophthalmology

NPI 1659340420

1740 SOUTH ST STE 400
Philadelphia, PA 19146

(267) 607-6888

✔ PECOS11 mi

Maximilian Padilla, M.D.

Ophthalmology

NPI 1235557166

11571 VERANDAH BLVD
Fort Myers, FL 33905

(239) 415-7576

✔ PECOS✔ Accepts Medicare982 mi

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 Ridley Creek Retina LLC's NPI number?

The NPI number for Ridley Creek Retina LLC is 1417564592. It was assigned to this organization in the NPPES registry on September 23, 2020.

Where is Ridley Creek Retina LLC located?

Ridley Creek Retina LLC is located at 200 E State St Ste 303, Media, PA 19063. The listed phone number is (610) 892-1708.

What is Ridley Creek Retina LLC's specialty?

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

Is Ridley Creek Retina LLC enrolled in Medicare?

Yes. Ridley Creek Retina LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Ridley Creek Retina LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians, all in Ophthalmology, reassign their Medicare billing to Ridley Creek Retina LLC. 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. Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Ridley Creek Retina LLC was last updated on December 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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.