Alizza Retter, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

4514 16TH Ave FL 4
Brooklyn, NY 11204-1101

Phone

(718) 407-7300

NPI assigned

Apr 29, 2014

Last updated

Jan 12, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Mercy College, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatologists of Illinois, PLLCGroup PAC ID 9537128004, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: aretter1047182@nychhc.direct-ci.com

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.

• Dermatologists of Illinois, PLLC

  dba The Skin Care Center

  • Dermatology Physician
  • Lake Forest, IL
  • NPI 1851358345
  Medicare reassignment Care Compare group
• Premium Health Inc

  • Federally Qualified Health Center (FQHC)
  • Brooklyn, NY
  • NPI 1609129402
  NPD

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

{
    "created_epoch": "1398729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1972913051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 FOSTER AVE STE 200",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112301399",
            "telephone_number": "718-407-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4514 16TH AVE FL 4",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112041101",
            "telephone_number": "718-407-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RETTER",
        "first_name": "ALIZZA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-29",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "017378",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06139179",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Retina Group, P.C.
• Jonathan Scott Retkinski, MS CCC-SLP
• Randi Retkinski
• Kristen Retta
• Susan Ilsa Rettek Hochberg, PH.D.
• Kelly Reuter, LCSW
• Marissa Ann Reuter, AU.D., CCC-A
• Matheresa Revamuntan, PT
• Ana Revazishvili
• Revcore Recovery Center of Manhattan, LLC

• Physician Assistant in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.