Individual provider Active NPI

Salar Rafieetary, MD

  • Retina Specialist (Ophthalmology) Physician
  • Germantown, TN
National Provider Identifier
1174052237
Registry record updated Jul 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
63136 Issued in TN
Practice address
1432 Kimbrough Rd
Germantown, TN 38138-2405
Phone
(901) 767-4499
NPI assigned
Jun 12, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X TN
Retina Specialist (Ophthalmology) Physician 207WX0107X 63136 TN Primary

Addresses

Primary practice location

1432 Kimbrough Rd
Germantown, TN 38138-2405

Mailing address

1432 Kimbrough Rd
Germantown, TN 38138-2405
Phone (901) 767-4499

Other practice location 1

2684 W Oxford Loop
Oxford, MS 38655-4466
Phone (662) 259-6102

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, AR, TN3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20210607002525 MS Practitioner - Ophthalmology 7315347754 Reassigns benefits to 1 organization
I20210608000235 AR Practitioner - Ophthalmology 7315347754 Reassigns benefits to 2 organizations
I20210608002346 TN Practitioner - Ophthalmology 7315347754 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charles Retina Institute PCGroup PAC ID 9830002583, 12 clinicians

Practice addresses (Care Compare)

1432 Kimbrough Rd
Germantown, TN 38138-2405
Phone (901) 767-4499

2085 Goodman Rd W
Horn Lake, MS 38637-1416
Phone (901) 767-4499

2684 W Oxford Loop
Oxford, MS 38655-4466
Phone (901) 767-4499

601 E Matthews Ave
Jonesboro, AR 72401-3145
Phone (901) 767-4499

Hospital & facility affiliations

  • Baptist Memorial Hospital Hospital, Memphis, TN, CCN 440048

Merit-based Incentive Payment System (MIPS)

Final score
88.15 of 100Reported as group
Quality
59.97
Promoting interoperability
100
Improvement activities
40
Cost
80.93

Merit-based Incentive Payment System (MIPS)

Final score
91.36 of 100Reported as group
Quality
82.73
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery23

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Charles Retina Institute PC CurrentSince Jul 1, 2021 Accepting new patients
St Bernards Hospital Inc. CurrentSince Oct 1, 2022 Accepting new patients

Locations

1201 Fleming Ave
Jonesboro, AR 72401
Phone (870) 932-0440

637 E Matthews Ave
Jonesboro, AR 72401
Phone (870) 931-3338

225 E Washington Ave
Jonesboro, AR 72401
Phone (870) 207-1630

601 E Matthews Ave
Jonesboro, AR 72401
Phone (870) 935-6396

303 W Polk Ave
West Memphis, AR 72301
Phone (423) 483-4496

303 W Polk Ave
Ste A
West Memphis, AR 72301
Phone (870) 732-2100

6947 Crumpler Blvd
Ste 101
Olive Branch, MS 38654

2684 West Oxford Loop
Oxford, MS 38655
Phone (901) 683-0399

391 Southcrest Cir
Ste 108
Southaven, MS 38671
Phone (662) 349-0910

7600 Airways Blvd
Ste F
Southaven, MS 38671
Phone (662) 349-5901

401 E Tickle St
Dyersburg, TN 38024
Phone (731) 286-2801

1432 Kimbrough Rd
Germantown, TN 38138

930 Madison Ave
Ste 200
Memphis, TN 38103
Phone (901) 448-6650

5350 Poplar Ave
Ste 950
Memphis, TN 38119
Phone (901) 683-4600

4759 Easley Ave
Millington, TN 38053
Phone (901) 448-6650

Interoperability endpoints

  • Direct secure messaging: srafieetary33418@mlh.direct-ci.com

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.

Hospital & facility affiliations 1

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": "1497225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1174052237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1432 KIMBROUGH RD",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381382405",
            "telephone_number": "901-767-4499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1432 KIMBROUGH RD",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381382405",
            "telephone_number": "901-767-4499"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2684 W Oxford Loop",
            "address_purpose": "LOCATION",
            "city": "Oxford",
            "state": "MS",
            "postal_code": "386554466",
            "country_code": "US",
            "telephone_number": "662-259-6102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAFIEETARY",
        "first_name": "SALAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-12",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TN",
            "license": null,
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "TN",
            "license": "63136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

Verify at the official NPI Registry.