CHARLES W TATTERSALL (M.D.) – Vascular Surgery Physician, NPI 1629048913
Vascular Surgery Physician
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Profile Insights
NPPES metrics only — not quality of care.
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
| Company | Amount |
|---|---|
| AngioDynamics, Inc. | $56 |
| Endologix LLC | $54 |
| Cardiovascular Systems Inc. | $15 |
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20041008000153 | I | Vascular Surgery | IN | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 41 | 41 | $0 |
| 36821 | Relocation of arm vein with connection to arm artery for hemodialysis | 34 | 34 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 33 | 31 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 25 | 25 | $0 |
| 76937 | Ultrasonic guidance for blood vessel access | 23 | 23 | $0 |
Insurance plans in this area (ZIP 48278)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| VASCULAR SURGERY | IN | 36556 | Insertion of central venous catheter for infusion, patient 5 years or older | 19 | 16 |
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