Individual provider Active NPI

Luis A Retamozo, MD

  • Family Medicine Physician
  • Burleson, TX
National Provider Identifier
1073574422
Registry record updated May 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
J6689 Issued in TX
Practice address
11797 South Fwy Ste 234
Burleson, TX 76028-7035
Phone
(817) 293-2944
Fax
(817) 293-2039
NPI assigned
Mar 28, 2006
Last updated
May 30, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X J6689 TX Primary

Addresses

Primary practice location

11797 South Fwy Ste 234
Burleson, TX 76028-7035

Mailing address

11797 South Fwy Ste 234
Burleson, TX 76028-7035
Phone (817) 293-2944

Other identifiers 3

IdentifierTypeStateIssuer
8J9051OtherTXBCBS
P00274097OtherTXRAILROAD MEDICARE PIN
1073574422MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041109001210 TX Practitioner - Family Practice 6901869098 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Huguley Medical Associates, IncGroup PAC ID 2668562471, 50 clinicians

Practice addresses (Care Compare)

11797 S Fwy
Suite 234
Burleson, TX 76028-7035
Phone (817) 293-2944

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.59 of 100Reported as group
Quality
74.14
Promoting interoperability
100
Improvement activities
40
Cost
71.17

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
K6689TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Huguley Medical Associates CurrentSince Jun 2, 2008 Accepting new patients

Locations

11797 South Fwy
Ste 234
Burleson, TX 76028

11797 South Fwy
Ste 242
Burleson, TX 76028
Phone (817) 568-1981

11801 South Fwy
Burleson, TX 76028
Phone (817) 551-2738

213 W Hillcrest St
Keene, TX 76059
Phone (817) 645-6852

Interoperability endpoints

  • Direct secure messaging: lretamozo660582@adventhealth.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1073574422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11797 SOUTH FWY STE 234",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760287035",
            "telephone_number": "817-293-2944",
            "fax_number": "817-291-2039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11797 SOUTH FWY STE 234",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760287035",
            "telephone_number": "817-293-2944",
            "fax_number": "817-293-2039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RETAMOZO",
        "first_name": "LUIS",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2023-05-30",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J6689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8J9051",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "P00274097",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073574422",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burleson, TX

Sources for this page

Verify at the official NPI Registry.