Individual provider Active NPI

Tamara Lynn Shrader, ACNP

  • Family Nurse Practitioner
  • Homer, AK
National Provider Identifier
1053797696
Registry record updated Oct 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
137323 Issued in AK
Practice address
4136 Bartlett St
Homer, AK 99603-7001
Phone
(907) 235-8586
NPI assigned
Aug 5, 2015
Last updated
Oct 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 137323 AK Primary

Addresses

Primary practice location

4136 Bartlett St
Homer, AK 99603-7001

Mailing address

4136 Bartlett St
Homer, AK 99603-7001
Phone (907) 299-0993

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, AK2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200329000170 NM Practitioner - Nurse Practitioner 2860821709 Reassigns benefits to 1 organization
I20211026003177 AK Practitioner - Nurse Practitioner 2860821709 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
70.59 of 100Reported as group
Quality
83.37
Promoting interoperability
100
Improvement activities
40
Cost
16.65

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Peninsula Hospital, Inc CurrentSince Apr 27, 2022 Accepting new patients
South Peninsula Hospital, Inc CurrentSince Sep 18, 2021 Accepting new patients
Unm Medical Group, Inc. CurrentSince Feb 24, 2020 Accepting new patients
South Peninsula Hospital, Inc. CurrentSince Sep 18, 2021 Accepting new patients
Unm Medical Group Inc CurrentSince Feb 24, 2020 Accepting new patients

Locations

4136 Bartlett St
Homer, AK 99603
Phone (907) 235-6127

4300 Bartlett St
Homer, AK 99603
Phone (907) 235-0369

933 Bradbury Dr SE
Ste 2222
Albuquerque, NM 87106
Phone (505) 272-1476

2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/sphosp-0c203fcf
  • Direct secure messaging: tamara.shrader.1@14977.direct.athenahealth.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1438732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1053797696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4136 BARTLETT ST",
            "city": "HOMER",
            "state": "AK",
            "postal_code": "996037001",
            "telephone_number": "907-299-0993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4136 BARTLETT ST",
            "city": "HOMER",
            "state": "AK",
            "postal_code": "996037001",
            "telephone_number": "907-235-8586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHRADER",
        "first_name": "TAMARA",
        "middle_name": "LYNN",
        "credential": "ACNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-05",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "137323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homer, AK

Sources for this page

Verify at the official NPI Registry.