Individual provider Active NPI

David L Rettig Jr., CRNA

  • Certified Registered Nurse Anesthetist
  • Dallas, TX
National Provider Identifier
1083712905
Registry record updated Jul 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
678659 Issued in TX
Practice address
6606 LBJ Fwy
Suite 200
Dallas, TX 75240
Phone
(972) 715-5000
Fax
(972) 715-9976
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X AP114534 TX
Certified Registered Nurse Anesthetist 367500000X 678659 TX Primary

Addresses

Primary practice location

6606 LBJ Fwy
Suite 200
Dallas, TX 75240

Mailing address

PO Box 840853
Dallas, TX 75284-0853
Phone (972) 233-1999

Other practice location 1

12222 Merit Dr Ste 600
Dallas, TX 75251-3294
Phone (972) 715-5000

Other identifiers 3

IdentifierTypeStateIssuer
P01446010OtherTXRR
8739UGOtherTXBCBS
179460405MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060420000400 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 4385653237 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
U S Anesthesia Partners of Texas, PA 2,750 clinicians

Practice addresses (Care Compare)

1301 Pennsylvania Ave
Fort Worth, TX 76104-2122
Phone (817) 250-2150

Merit-based Incentive Payment System (MIPS)

Final score
88.94 of 100Reported as group
Quality
91.31
Improvement activities
40
Cost
79.05

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
678659TXMDCertified Registered Nurse Anesthetist
AP114534TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
U S Anesthesia Partners of Texas, PA Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2014 Accepting new patients
U. S. Anesthesia Partners of Texas, P.a., Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2014 Accepting new patients

Locations

12222 Merit Dr
Ste 600
Dallas, TX 75251
Phone (972) 361-1844

1301 Pennsylvania Ave
Ft Worth, TX 76104
Phone (817) 250-2000

1800 Park Place Ave
Ft Worth, TX 76110
Phone (682) 703-5600

7600 Beechnut St
Houston, TX 77074
Phone (713) 456-5000

100 Medical Dr
Lake Jackson, TX 77566
Phone (713) 496-7555

4401 Booth Calloway Rd
Richland Hls, TX 76180
Phone (817) 255-1000

9250 Pinecroft Dr
Shenandoah, TX 77380
Phone (281) 364-2300

Organizations & group practices 2

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1083712905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840853",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840853",
            "telephone_number": "972-233-1999",
            "fax_number": "972-233-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6606 LBJ FWY",
            "address_2": "SUITE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75240",
            "telephone_number": "972-715-5000",
            "fax_number": "972-715-9976"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12222 Merit Dr Ste 600",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752513294",
            "country_code": "US",
            "telephone_number": "972-715-5000",
            "fax_number": "972-715-9976",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RETTIG",
        "first_name": "DAVID",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP114534",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "678659",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR",
            "identifier": "P01446010",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8739UG",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "179460405",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.