J WALDEN RETAN M.D. NPI 1225104094

Internal Medicine in Talladega, AL

NPI 1225104094 Individual Male Years of Experience 66 Internal Medicine PECOS Enrolled Accepts Medicare Approved Payment

NPI Profile for J WALDEN RETAN M.D.

J Retan is an internal medicine provider established in Talladega, Alabama and his medical specialization is internal medicine with more than 66 years of experience. He graduated from State University Of Ny Upstate Medical University in 1957. The NPI number of J Retan is 1225104094 and was assigned on November 2006. The practitioner's primary taxonomy code is 207R00000X with license number 3223 (AL). The provider is registered as an individual and his NPI record was last updated 9 years ago.

An internist like J Walden Retan M.d. is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

J Retan is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

J Retan is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data he has hospital affiliations with University Of Alabama Hospital.

The typical physician office visit costs for Medicare beneficiaries in this area are: $32.26 for a new patient copayment and $24.83 for an established patient copayment.

NPI

1225104094

Provider Name J WALDEN RETAN M.D.
Provider Location Address177 OAK RIDGE LN TALLADEGA, AL 35160
Provider Mailing Address177 OAK RIDGE LN TALLADEGA, AL 35160
GenderMale
NPI Entity TypeIndividual
Medical School NameSTATE UNIVERSITY OF NY UPSTATE MEDICAL UNIVERSITY
Graduation Year1957
Is Sole Proprietor?Yes
Is Organization Subpart?N/A
Enumeration Date11-25-2006
Last Update Date02-05-2013


Primary Taxonomy

Taxonomy Code207R00000X
ClassificationInternal Medicine
TypeAllopathic & Osteopathic Physicians
License No.3223
License StateAL
Taxonomy DescriptionA physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Business Address

J WALDEN RETAN M.D.
177 OAK RIDGE LN
TALLADEGA, AL
ZIP 35160
Phone: (205) 266-4928

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Mailing Address

J WALDEN RETAN M.D.
177 OAK RIDGE LN
TALLADEGA, AL
ZIP 35160
Phone: (205) 266-4928



PECOS Enrollment and Medicare Participation

What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.

Registered in PECOS? Yes
PECOS PAC ID446200778
PECOS Enrollment IDI20050308000729
Accepts Medicare Assignment? Yes "What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

Physician Office Visit Costs

The provider accepts as payment the Medicare approved amount. Medicare beneficiaries should not be billed for more than the Medicare deductible and coinsurance amounts. Medicare pricing is usually a reference point for private insurance covered patients. The prices below reflect the costs for new and established patients in the 35160 ZIP code area.

New Patients Office Visits Costs *
Most Utilized Procedure Code for new patients office visits: 99204
Minimum New Patient Pricing Maximum New Patient Pricing Typical New Patient Pricing
$55.54 $170.61 $129.05
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$13.88 $42.65 $32.26
Established Patients Office Visits Costs *
Most Utilized Procedure Code for established patients office visits: 99214
Minimum Established Patient Pricing Maximum Established Patient Pricing Typical Established Patient Pricing
$16.93 $139.08 $99.33
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.23 $34.77 $24.83

* The physician office visit costs information is obtained by Medicare's statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Hospital Affiliations

Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. J Retan is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
UNIVERSITY OF ALABAMA HOSPITAL619 SOUTH 19TH STREET
BIRMINGHAM, AL 35233
(205) 934-4011Acute Care Hospitals10033

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine3223ALNo

Taxonomy Description: an internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
5241MEDICAID (05)AL

NPI Validation Check Digit Calculation


The following table explains step by step the NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1225104094
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2245208018
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 4 + 5 + 2 + 0 + 8 + 0 + 1 + 8 + 24 = 56
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 56 = 44

The NPI number 1225104094 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
J Walden Retan M.d. is registered as an entity type code: 1. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:

  • 1 = Person: individual human being who furnishes health care.
  • 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.