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RETINA INSTITUTE OF INDIANA, P.C.
NPI 1457492167
Ophthalmology in Fort Wayne, IN

Active since February 08, 2007CLIA 15D2047924 · Waiver
11188 DIEBOLD RD, FORT WAYNE, IN 46845(260) 483-9500(260) 483-9511 Get Directions Write a Review

NPPES record last updated: March 17, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Retina Institute Of Indiana, P.c. NPPES

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

RETINA INSTITUTE OF INDIANA, P.C. (NPI 1457492167), doing business as Vitreoretinal Consultants Of Fort Wayne, P.c., is a healthcare organization registered as an ophthalmology in Fort Wayne, Indiana and active in the NPI registry since February 2007. The organization holds a CLIA Waiver certificate valid through October 4, 2026 and lists Gohar Azam Salam, Owner, as its authorized official.

NPPES Registry Identity

NPI1457492167
Entity TypeOrganization
Primary Taxonomy207W00000X
Legal Business NameRETINA INSTITUTE OF INDIANA, P.C.
Location Address11188 DIEBOLD RDFort Wayne, IN 46845-9662
Mailing Address11188 Diebold Rd.Fort Wayne, IN 46845-1712 · (260) 483-9500 · Fax (260) 483-9511
Phone(260) 483-9500
Fax(260) 483-9511
Organization SubpartNo
Authorized OfficialGohar Azam SalamOwner · (260) 483-9500
Enumeration DateFebruary 8, 2007
Last NPPES UpdateMarch 17, 2016
✔ NPI 1457492167 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License✔ Licensed in IN · 50004672A
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.
11188 DIEBOLD RD, Fort Wayne, IN 46845
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Other Names 1

Former Legal Business NameVitreoretinal Consultants Of Fort Wayne, P.c.

Other Identifiers 6

Other17842IN · Php
Medicaid200522580AIN
Medicare PIN229700IN
Medicare PINDF2992IN
Other000000364631IN · Anthem Blue Cross
Other7800696IN · Aetna

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 15D2047924

Retina Institute Of Indiana · Fort Wayne, IN
Active · expires Oct 4, 2026
CLIA Number15D2047924
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateOctober 5, 2024
Certificate Expiration DateOctober 4, 2026
Laboratory DirectorGohar A. Salam
Laboratory Phone(260) 483-9500
Laboratory LocationRetina Institute Of Indiana11192 Diebold Rd, Fort Wayne, IN 46845
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. GOHAR A SALAM M.D., F.A.C.S.
Ophthalmology
11188 DIEBOLD RD
FORT WAYNE, IN 46845
Allen County (260) 483-9500
DR. ADEEL N KHAN M.D.
Ophthalmology
11188 DIEBOLD RD
FORT WAYNE, IN 46845
Allen County (260) 483-9500

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 Institute Of Indiana, P.C.'s NPI number?

The NPI number for Retina Institute Of Indiana, P.C. is 1457492167. It was assigned to this organization in the NPPES registry on February 8, 2007. The provider was formerly known as Vitreoretinal Consultants Of Fort Wayne, P.C..

Where is Retina Institute Of Indiana, P.C. located?

Retina Institute Of Indiana, P.C. is located at 11188 Diebold Rd, Fort Wayne, IN 46845. The listed phone number is (260) 483-9500.

What is Retina Institute Of Indiana, P.C.'s specialty?

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

Does Retina Institute Of Indiana, P.C. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 15D2047924) is associated with this NPI, valid through October 4, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Retina Institute Of Indiana, P.C. was last updated on March 17, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.