Individual provider Active NPI

Thomas L Retzios, DPM

  • Podiatrist
  • Miamisburg, OH
National Provider Identifier
1558366393
Registry record updated Jul 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
36002703 Issued in OH
Practice address
2 Prestige PL Ste 210
Miamisburg, OH 45342-6141
Phone
(937) 223-2300
Fax
(937) 223-2333
NPI assigned
Jun 17, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 36002703 OH Primary

Addresses

Primary practice location

2 Prestige PL Ste 210
Miamisburg, OH 45342-6141

Mailing address

PO Box 621015
Cincinnati, OH 45262-1015
Phone (937) 223-2300

Other identifiers 1

IdentifierTypeStateIssuer
0845858MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060117000734 OH Practitioner - Podiatry 2163446220 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2 Prestige PL
Suite 210
Miamisburg, OH 45342-6141
Phone (937) 223-2300

Hospital & facility affiliations

  • Atrium Medical Center Hospital, Franklin, OH, CCN 360076
  • Miami Valley Hospital Hospital, Dayton, OH, CCN 360051

Merit-based Incentive Payment System (MIPS)

Final score
90.79 of 100Reported as individual
Quality
91.43
Promoting interoperability
85
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue46
Removal of nail tissue731
Removal or shaving of skin growth223

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2703OHMDChiropractor
36002703OHMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas L Retzios DPM Inc Podiatrist CurrentSince Sep 1, 2010 Accepting new patients

Locations

601 S Edwin C Moses Blvd
Ste A
Dayton, OH 45417
Phone (937) 223-2300

2 Prestige Pl
Ste 210
Miamisburg, OH 45342
Phone (937) 223-2300

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.

Hospital & facility affiliations 2

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": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595289600000",
    "number": "1558366393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 621015",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452621015",
            "telephone_number": "937-223-2300",
            "fax_number": "937-223-2333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 PRESTIGE PL STE 210",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453426141",
            "telephone_number": "937-223-2300",
            "fax_number": "937-223-2333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RETZIOS",
        "first_name": "THOMAS",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36002703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0845858",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miamisburg, OH

Sources for this page

Verify at the official NPI Registry.