Individual provider Active NPI

Nicole Neretin, MD

  • Family Medicine Physician
  • New York, NY
National Provider Identifier
1649270612
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
201954 Issued in NY
Practice address
16 E 16TH St
New York, NY 10003-3105
Phone
(212) 924-7744
NPI assigned
Jul 29, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 201954 NY Primary

Addresses

Primary practice location

16 E 16TH St
New York, NY 10003-3105

Mailing address

16 E 16TH St
New York, NY 10003-3105
Phone (212) 924-7744

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
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
I20230812000040 AK Practitioner - Family Practice 7214063742 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Norton Sound Health Corporation Current Accepting new patients
Norton Sound Health Corporation Family Medicine CurrentSince May 28, 2023 Accepting new patients
Norton Sound Health Corporation CurrentSince May 28, 2023 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: neretin@direct.nshcorp.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649270612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 E 16TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033105",
            "telephone_number": "212-924-7744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 E 16TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033105",
            "telephone_number": "212-924-7744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NERETIN",
        "first_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "201954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.