Charles W Tattersall, M.D.

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

01059210A Issued in IN

Practice address

261 Paul Revere Dr
Chesterton, IN 46304-9371

Phone

(219) 877-2225

NPI assigned

Jan 26, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: ctattersall82998@direct.franciscanalliance.org

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.

• Franciscan Health Crown Point

  • Community/Retail Pharmacy
  • Crown Point, IN
  • NPI 1184250623
  NPD (past)
• Vascular Surgery & Technology

  • Vascular Surgery Physician
  • Chesterton, IN
  • NPI 1841248218
  NPD (past)

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1629048913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 PAUL REVERE DR",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463049371",
            "telephone_number": "219-877-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 PAUL REVERE DR",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463049371",
            "telephone_number": "219-877-2225"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8865 W 400 N Ste 175",
            "address_purpose": "LOCATION",
            "city": "Michigan City",
            "state": "IN",
            "postal_code": "463609010",
            "country_code": "US",
            "telephone_number": "219-877-2225",
            "fax_number": "219-877-2230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TATTERSALL",
        "first_name": "CHARLES",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "IN",
            "license": "01059210A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200487840",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ctattersall82998@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "8865 W 400 N",
            "address_2": "Suite 175",
            "city": "Michigan City",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463609222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Karen V Sutherland, LMFT
• Sabiha Syed
• Symphony of Chesterton LLC
• Eric Kristian Szczesniak, M.D.
• Jacqueline Yong Xing Talbot, SLP-CFY
• Brittany Thacker
• The Artistic Recovery, Inc.
• The Kratz Group Inc
• The Waters of Duneland, LLC
• Bruce J Thoma, M.D.

• Vascular Surgery Physician in Chesterton, IN
• Providers in Chesterton, IN by specialty
• Vascular Surgery Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.