Individual provider Active NPI

Nicholas Machael Vetrano, M.D.

  • Emergency Medicine Physician
  • Tuscaloosa, AL
National Provider Identifier
1083848808
Registry record updated Apr 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
30422 Issued in AL
Practice address
809 University Blvd E
Tuscaloosa, AL 35401-2029
Phone
(205) 759-7122
NPI assigned
May 7, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 30422 AL Primary
Emergency Medicine Physician 207P00000X 77803 GA
Emergency Medicine Physician 207P00000X 24735 MS

Addresses

Primary practice location

809 University Blvd E
Tuscaloosa, AL 35401-2029

Mailing address

809 University Blvd E
Tuscaloosa, AL 35401-2029
Phone (205) 759-7122

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20101123000961 AL Practitioner - Emergency Medicine 3072709591 Reassigns benefits to 1 organization
I20170711000937 GA Practitioner - Emergency Medicine 3072709591 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Alabama School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carrollton Emergency Physicians PCGroup PAC ID 7416860010, 34 clinicians

Practice addresses (Care Compare)

705 Dixie St
Carrollton, GA 30117-3818
Phone (770) 812-9666

Hospital & facility affiliations

  • Tanner Medical Center - Carrollton Hospital, Carrollton, GA, CCN 110011
  • Tanner Medical Center Villa Rica Hospital, Villa Rica, GA, CCN 110015
  • Higgins General Hospital Hospital, Bremen, GA, CCN 111320

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
77803GAMDEmergency Medicine Physician
24735MSMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Independence Emergency Physicians LLC Emergency Medicine CurrentSince Jun 1, 2017 Accepting new patients
Paragon Contracting Services LLC Emergency Medicine CurrentSince Aug 1, 2011 Accepting new patients
Carrollton Emergency Physicians, PC Emergency Medicine CurrentSince Jul 1, 2017 Accepting new patients

Locations

810 Saint Vincents Dr
Birmingham, AL 35205
Phone (205) 930-2456

2105 E South Blvd
Montgomery, AL 36116
Phone (334) 286-2842

809 University Blvd E
Tuscaloosa, AL 35401
Phone (205) 333-4661

200 Allen Memorial Dr
Bremen, GA 30110
Phone (770) 537-5851

705 Dixie St
Carrollton, GA 30117
Phone (770) 812-9666

601 Dallas Hwy
Villa Rica, GA 30180
Phone (770) 456-3000

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1241654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493251200000",
    "number": "1083848808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 UNIVERSITY BLVD E",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354012029",
            "telephone_number": "205-759-7122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 UNIVERSITY BLVD E",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354012029",
            "telephone_number": "205-759-7122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VETRANO",
        "first_name": "NICHOLAS",
        "middle_name": "MACHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-07",
        "last_updated": "2017-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AL",
            "license": "30422",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "77803",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "24735",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

Verify at the official NPI Registry.