RETINAL CONSULTANTS OF SOUTHERN CALIFORNIA MEDICAL GROUP, INC
NPI 1700807815
Specialist in Westlake Village, CA

Q: What is Retinal Consultants Of Southern California Medical Group, Inc's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Active since July 22, 2006

1220 LA VENTA DR, SUITE 211, WESTLAKE VILLAGE, CA 91361(805) 379-0200(805) 496-5204 Get Directions Write a Review

NPPES record last updated: September 26, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 1, 2021, Jun 1, 2017 (2 updates tracked since 2017).

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About Retinal Consultants Of Southern California Medical Group, Inc NPPES

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

RETINAL CONSULTANTS OF SOUTHERN CALIFORNIA MEDICAL GROUP, INC (NPI 1700807815) is a healthcare organization registered as a specialist in Westlake Village, California and active in the NPI registry since July 2006. The organization lists Kenneth Robert Diddie, President, as its authorized official.

NPPES Registry Identity

NPI1700807815

Entity TypeOrganization

Primary Taxonomy174400000X

Legal Business NameRETINAL CONSULTANTS OF SOUTHERN CALIFORNIA MEDICAL GROUP, INC

Location Address1220 LA VENTA DR, SUITE 211Westlake Village, CA 91361-3703

Mailing Address1220 La Venta Dr, Suite 211Westlake Village, CA 91361-3703 · (805) 379-0200 · Fax (805) 496-5204

Phone(805) 379-0200

Fax(805) 496-5204

Organization SubpartNo

Authorized OfficialKenneth Robert DiddiePresident · (805) 379-0200

Enumeration DateJuly 22, 2006

Last NPPES UpdateSeptember 26, 20232 updates tracked since enumeration

NPPES CertifiedSeptember 26, 2023

✔ NPI 1700807815 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

License✔ Licensed in CA · G33939

Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

1220 LA VENTA DR, Westlake Village, CA 91361

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Other Identifiers 2

OtherCP5288CA · Railroad Medicare

Medicaid00G339391CA

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Retinal Consultants Of Southern California Medical Group, Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Retinal Consultants Of Southern California Medical Group, Inc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Kenneth Diddie, M.D.

Ophthalmology

NPI 1184684219

1220 LA VENTA DR SUITE 211
Westlake Village, CA 91361

(805) 379-0200

✔ 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 Retinal Consultants Of Southern California Medical Group, Inc's NPI number?

The NPI number for Retinal Consultants Of Southern California Medical Group, Inc is 1700807815. It was assigned to this organization in the NPPES registry on July 22, 2006.

Where is Retinal Consultants Of Southern California Medical Group, Inc located?

Retinal Consultants Of Southern California Medical Group, Inc is located at 1220 La Venta Dr Suite 211, Westlake Village, CA 91361. The listed phone number is (805) 379-0200.

What is Retinal Consultants Of Southern California Medical Group, Inc's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Retinal Consultants Of Southern California Medical Group, Inc enrolled in Medicare?

Yes. Retinal Consultants Of Southern California Medical Group, Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Retinal Consultants Of Southern California Medical Group, Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Ophthalmology) reassigns their Medicare billing to Retinal Consultants Of Southern California Medical Group, Inc. 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.

When was this NPI record last updated?

The NPPES record for Retinal Consultants Of Southern California Medical Group, Inc was last updated on September 26, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.