Individual provider Active NPI

Nicholas Chris Retson, MD

  • Plastic Surgery Physician
  • Merrillville, IN
National Provider Identifier
1417020504
Registry record updated Aug 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
01026350 Issued in IN
Practice address
8053 Cleveland PL
Merrillville, IN 46410-5303
Phone
(219) 769-4456
Fax
(219) 769-1468
NPI assigned
Nov 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 01026350 IN Primary
Surgery of the Hand (Plastic Surgery) Physician 2082S0105X 01026350 IN

Addresses

Primary practice location

8053 Cleveland PL
Merrillville, IN 46410-5303

Mailing address

8053 Cleveland PL
Merrillville, IN 46410-5303
Phone (219) 769-4456

Other identifiers 2

IdentifierTypeStateIssuer
100339140AMedicaidIN
0000000184599OtherINANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20080724000098 IN Practitioner - Plastic and Reconstructive Surgery 7719050780

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01026350INMDSurgery of the Hand (Plastic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Retson Plastic Surgerypc Plastic Surgery CurrentSince Jan 1, 2008 Accepting new patients

Locations

8053 Cleveland Pl
Merrillville, IN 46410
Phone (219) 769-4456

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250208000000",
    "number": "1417020504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8053 CLEVELAND PL",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464105303",
            "telephone_number": "219-769-4456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8053 CLEVELAND PL",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464105303",
            "telephone_number": "219-769-4456",
            "fax_number": "219-769-1468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RETSON",
        "first_name": "NICHOLAS",
        "middle_name": "CHRIS",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2009-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "IN",
            "license": "01026350",
            "primary": true
        },
        {
            "code": "2082S0105X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "IN",
            "license": "01026350",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100339140A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "0000000184599",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrillville, IN

Sources for this page

Verify at the official NPI Registry.