RIDLEY CREEK RETINA LLC
NPI 1417564592
Ophthalmology in Media, PA

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: August 16, 2026.

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

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
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
200 E STATE ST STE 303, Media, PA 19063

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

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.

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 7 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.