Individual provider Active NPI

Wayne C Pretila, MD

  • Anesthesiology Physician
  • Lexington, KY
National Provider Identifier
1790750230
Registry record updated Jun 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
01026839A Issued in IN
Practice address
425 Lewis Hargett Cir
Lexington, KY 40503-3590
Phone
(859) 268-1030
Fax
(859) 269-4120
NPI assigned
Feb 20, 2006
Last updated
Jun 1, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2016

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 01026839A IN Primary

Addresses

Primary practice location

425 Lewis Hargett Cir
Lexington, KY 40503-3590

Mailing address

1451 N Gardner St
Scottsburg, IN 47170-7751
Phone (812) 752-3456

Other identifiers 2

IdentifierTypeStateIssuer
940540UUOtherINLEGACY MEDICARE
100221310MedicaidIN

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20090917000459 IN Practitioner - Anesthesiology 0042366932 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
One Anesthesia PLLCGroup PAC ID 7113816174, 13 clinicians

Practice addresses (Care Compare)

1220 Missouri Ave
RM 2547
Jeffersonville, IN 47130-3725
Phone (812) 282-6631

1451 N Gardner St
Norton Scott Hospital
Scottsburg, IN 47170-7751
Phone (812) 752-3456

1850 State St
New Albany, IN 47150-4990
Phone (812) 944-7701

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky Anesthesia Group, PSC Anesthesiology CurrentSince Feb 20, 2016 Accepting new patients
One Anesthesia PLLC Anesthesiology CurrentSince Aug 1, 2024 Accepting new patients

Locations

1220 Missouri Ave
Rm 2547
Jeffersonville, IN 47130

1850 State St
New Albany, IN 47150
Phone (812) 944-7701

1451 N Gardner St
Scottsburg, IN 47170
Phone (812) 752-8500

275 Highway 770
Corbin, KY 40701
Phone (606) 526-7874

425 Lewis Hargett Cir
Lexington, KY 40503
Phone (606) 679-9322

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1140393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464739200000",
    "number": "1790750230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1451 N GARDNER ST",
            "city": "SCOTTSBURG",
            "state": "IN",
            "postal_code": "471707751",
            "telephone_number": "812-752-3456",
            "fax_number": "812-752-5884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 LEWIS HARGETT CIR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405033590",
            "telephone_number": "859-268-1030",
            "fax_number": "859-269-4120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRETILA",
        "first_name": "WAYNE",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-20",
        "last_updated": "2016-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01026839A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LEGACY MEDICARE",
            "identifier": "940540UU",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100221310",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.