Individual provider Active NPI

Sean Henry Tretiak, M.D.

  • Anesthesiology Physician
  • Torrance, CA
National Provider Identifier
1427077569
Registry record updated Jul 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A65535 Issued in CA
Practice address
3330 Lomita Blvd
Torrance, CA 90505-5002
Phone
(310) 325-9110
Fax
(310) 784-8762
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A65535 CA Primary

Addresses

Primary practice location

3330 Lomita Blvd
Torrance, CA 90505-5002

Mailing address

PO Box 60790
Pasadena, CA 91116-6790
Phone (626) 795-6596

Other identifiers 2

IdentifierTypeStateIssuer
00A655350MedicaidCA
00A655350OtherCABLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20050907000619 CA Practitioner - Anesthesiology 0446282776 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
George Washington University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Torrance Anesthesia Medical Group Inc.Group PAC ID 5395726491, 47 clinicians

Practice addresses (Care Compare)

3330 Lomita Blvd
Torrance, CA 90505-5002
Phone (310) 325-9110

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Torrance Anesthesia Medical Group Inc. Anesthesiology CurrentSince Jan 2, 2005 Accepting new patients
Torrance Memorial Medical Center Past Accepting new patients

Locations

3330 Lomita Blvd
Fl 5
Torrance, CA 90505
Phone (310) 517-4735

3330 Lomita Blvd
Torrance, CA 90505
Phone (310) 517-4675

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500940800000",
    "number": "1427077569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60790",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911166790",
            "telephone_number": "626-795-6596",
            "fax_number": "770-701-6651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 LOMITA BLVD",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905055002",
            "telephone_number": "310-325-9110",
            "fax_number": "310-784-8762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRETIAK",
        "first_name": "SEAN",
        "middle_name": "HENRY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2017-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A65535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A655350",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00A655350",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.