CHARLES W TATTERSALL (M.D.) – Vascular Surgery Physician, NPI 1629048913

CHARLES W TATTERSALL (M.D.) is a healthcare provider. based in Detroit, Michigan. specializing in Vascular Surgery Physician. They hold the professional credentials M.D.. They hold a License No. 01059210A (IN). The NPI Number for CHARLES W TATTERSALL (M.D.) is 1629048913

Main info

Male
Sole Proprietor
42 Years Of Experience
Accepts Medicare Assignment
Name
CHARLES W TATTERSALL (M.D.)
NPI
1629048913
Phone
(317) 528-4800
Address
PO BOX 781076
Enumeration Date
26 January 2006
Last Update Date
8 November 2024

Doctor Profile

Medical School Name
MEDICAL COLLEGE OF OHIO
Secondary Phone
-
Graduation Year
1984 (42 years ago)
PAC ID
0042279697
Professional Enrollment ID
I20041008000153

Contacts

Secure Messaging
ctattersall82998@Direct.FranciscanAlliance.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness85
Years active:20State licenses:1Other namesUpdated within 12 months

Provider Addresses for CHARLES W TATTERSALL (M.D.)

  • PO BOX 781076

    DETROIT, MI 482781076

    Phone: (317) 528-4800

    Fax: (317) 528-4800

    Type: Mailing

  • 8865 W 400 N Ste 175

    Michigan City, IN 463609010

    Phone: (219) 877-2225

    Fax: (219) 877-2230

    Type: Location

  • 261 PAUL REVERE DR

    CHESTERTON, IN 463049371

    Phone: (219) 877-2225

    Type: Mailing

  • West, Shelby Charter Township, Macomb County, Michigan, 48315, United States

    SUITE 175

    MICHIGAN CITY, IN 463609222

    Phone: (219) 877-2225

    Fax: (219) 877-2230

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $126.

Total Amount is formed as General ($126) + Research ($0) + Ownership ($0) = $126.

Last reported payment date: 2024-04-29 • Largest payer in this snapshot: AngioDynamics, Inc. ($56).

Total Amount

$126

General + Research + Ownership

Payments

3

Total payment records

General Amount

$126

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-04-29

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-10-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20041008000153IVascular SurgeryINTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99204New patient office or other outpatient visit, 45-59 minutes4141$0
36821Relocation of arm vein with connection to arm artery for hemodialysis3434$0
99213Established patient office or other outpatient visit, 20-29 minutes3331$0
99203New patient office or other outpatient visit, 30-44 minutes2525$0
76937Ultrasonic guidance for blood vessel access2323$0
View full utilization report →

Insurance plans in this area (ZIP 48278)

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Provider's Procedures

CHARLES W TATTERSALL (M.D.) performs procedures in Vascular Surgery Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
VASCULAR SURGERYIN36556Insertion of central venous catheter for infusion, patient 5 years or older1916

Reviews

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Frequently asked questions

Is there an official ID for CHARLES W TATTERSALL (M.D.) in U.S. healthcare records?
The official identifier for CHARLES W TATTERSALL (M.D.) is NPI 1629048913.
Is CHARLES W TATTERSALL (M.D.) still an active registrant?
CHARLES W TATTERSALL (M.D.) carries an active NPI according to the public dataset.
What expertise is attributed to CHARLES W TATTERSALL (M.D.)?
CHARLES W TATTERSALL (M.D.)'s specialty line reads Vascular Surgery Physician. Clinical services aligned with this taxonomy classification.
Where in Michigan is CHARLES W TATTERSALL (M.D.) registered?
Use Detroit, Michigan as the headline location for CHARLES W TATTERSALL (M.D.) here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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