Individual provider Active NPI

Theresa Marie Tretter, MD

  • Ophthalmology Physician
  • Warwick, RI
National Provider Identifier
1528110244
Registry record updated Aug 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD16398 Issued in RI
Practice address
566 Toll Gate Rd
Warwick, RI 02886
Phone
(401) 738-4800
Fax
(401) 738-8153
NPI assigned
Jan 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 197268 NY
Ophthalmology Physician 207W00000X MD16398 RI Primary

Addresses

Primary practice location

566 Toll Gate Rd
Warwick, RI 02886

Mailing address

566 Toll Gate Rd
Warwick, RI 02886-2799
Phone (401) 738-4800

Other practice location 1

615 Greenwich Ave Ste 10
Warwick, RI 02886-1882
Phone (401) 244-5186

Other practice location 2

36 7th Ave
Ste 515
New York, NY 10011
Phone (212) 284-9707

Other identifiers 14

IdentifierTypeStateIssuer
0498535OtherGHI
1926266OtherUNITED
11006585OtherACS MULTIPLAN
P1497267OtherNYOXFORD
01860122MedicaidNY
7860722OtherCIGNA
197268A40OtherHEALTHFIRST
32259POtherHIP
421B01OtherNYBCBS
4C3021OtherHEALTHNET
0100703OtherAMERICHOICE
396067OtherCONNECTICARE
5490713OtherAETNA
TT7268OtherATLANTIS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20120131000311 NY Practitioner - Ophthalmology 5496912628 Reassigns benefits to 1 organization
Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
New York Medical College, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

310 E 14TH St
Opthalmology Department of Mount Sinai
New York, NY 10003-4201
Phone (212) 241-0939

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
197268NYMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Ophthalmology CurrentSince Mar 1, 2021 Accepting new patients
Icahn School of Medicine at Mount Sinai Ophthalmology CurrentSince Mar 1, 2021 Accepting new patients
Solo Optometry PC Past Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients
Daniel E. Goldberg, MD, PC Ophthalmology Past Accepting new patients

Locations

218 2nd Ave
New York, NY 10003
Phone (212) 979-4000

310 E 14th St
New York, NY 10003
Phone (212) 979-4000

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 5

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": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534809600000",
    "number": "1528110244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "566 TOLL GATE RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028862799",
            "telephone_number": "401-738-4800",
            "fax_number": "401-738-8153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "566 TOLL GATE RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "02886",
            "telephone_number": "401-738-4800",
            "fax_number": "401-738-8153"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "615 Greenwich Ave Ste 10",
            "address_purpose": "LOCATION",
            "city": "Warwick",
            "state": "RI",
            "postal_code": "028861882",
            "country_code": "US",
            "telephone_number": "401-244-5186",
            "fax_number": "401-396-2393",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "36 7th Ave",
            "address_2": "Ste 515",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10011",
            "country_code": "US",
            "telephone_number": "212-284-9707",
            "fax_number": "212-284-0708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRETTER",
        "first_name": "THERESA",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2018-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "197268",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "RI",
            "license": "MD16398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0498535",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED",
            "identifier": "1926266",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACS MULTIPLAN",
            "identifier": "11006585",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P1497267",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01860122",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "7860722",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHFIRST",
            "identifier": "197268A40",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP",
            "identifier": "32259P",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "421B01",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "4C3021",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "0100703",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "396067",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5490713",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ATLANTIS",
            "identifier": "TT7268",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

Verify at the official NPI Registry.