Individual provider Active NPI

Eric Michael Rettig, O.D

  • Optometrist
  • Altoona, PA
National Provider Identifier
1053750547
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG002781 Issued in PA
Practice address
1418 11TH Ave
Altoona, PA 16601-3304
Phone
(814) 946-3937
Fax
(814) 944-8265
NPI assigned
Jun 18, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG002781 PA Primary

Addresses

Primary practice location

1418 11TH Ave
Altoona, PA 16601-3304

Mailing address

1418 11TH Ave
Altoona, PA 16601-3304
Phone (814) 946-3937

Other identifiers 1

IdentifierTypeStateIssuer
1028354500001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130807000709 PA Practitioner - Optometry 9335381151 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain View Eye Associates IncGroup PAC ID 4385616143, 5 clinicians

Practice addresses (Care Compare)

1418 11TH Ave
Altoona, PA 16601-3304
Phone (814) 946-3937

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery26

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG002781PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain View Eye Associates Inc Optometrist CurrentSince Jun 6, 2013 Accepting new patients

Locations

1418 11th Ave
Altoona, PA 16601
Phone (724) 543-2146

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1371513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1053750547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1418 11TH AVE",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166013304",
            "telephone_number": "814-946-3937",
            "fax_number": "814-944-8265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1418 11TH AVE",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166013304",
            "telephone_number": "814-946-3937",
            "fax_number": "814-944-8265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RETTIG",
        "first_name": "ERIC",
        "middle_name": "MICHAEL",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-18",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG002781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1028354500001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Altoona, PA

Sources for this page

Verify at the official NPI Registry.