Laurel Retay, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

3218 Issued in AZ

Practice address

2055 E Southern Ave
Suite D
Tempe, AZ 85282-7507

Phone

(480) 345-7676

Fax

(480) 345-3560

NPI assigned

Sep 29, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21922/brand/1/csg/1/fhir/r4

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.

• Monaliza Setudehnia MD PLLC

  • Internal Medicine Physician
  • Tempe, AZ
  • NPI 1922119270
  NPD (past)
• Paragon Medical Associates

  • Family Medicine Physician
  • Mesa, AZ
  • NPI 1194907154
  NPD (past)

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534204800000",
    "number": "1154318665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 S DELAWARE DR",
            "address_2": "STE 2",
            "city": "APACHE JUNCTION",
            "state": "AZ",
            "postal_code": "851206512",
            "telephone_number": "480-646-1001",
            "fax_number": "480-646-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 E SOUTHERN AVE",
            "address_2": "SUITE D",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827507",
            "telephone_number": "480-345-7676",
            "fax_number": "480-345-3560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RETAY",
        "first_name": "LAUREL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-29",
        "last_updated": "2018-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "3218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Resilient Reentry Agency
• Resolute Counseling, PLLC
• Respira LLC
• Restoration Nutrition LLC
• Restorative Healing and Counseling Center LLC
• Revamp Wellness Center
• Revive Community Health
• Revive Hive LLC
• Revive Physical Therapy and Wellness, PLLC
• Jascelyn Ann Revland, M.A.

• Internal Medicine Physician in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.