Individual provider Active NPI

Nicole A. Tradup, O.D.

  • Optometrist
  • Gardnerville, NV
National Provider Identifier
1114016938
Registry record updated Mar 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
595 Issued in NV
Practice address
1559 Watasheamu Rd
Gardnerville, NV 89460-7455
Phone
(928) 600-7008
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2401 CO
Optometrist 152W00000X 595 NV Primary

Addresses

Primary practice location

1559 Watasheamu Rd
Gardnerville, NV 89460-7455

Mailing address

1559 Watasheamu Rd
Gardnerville, NV 89460-7455
Phone (775) 265-4215

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040929001071 TX Practitioner - Optometry 2163491796 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1559 Watasheamu Rd
Gardnerville, NV 89460-7455

Merit-based Incentive Payment System (MIPS)

Final score
73.59 of 100Reported as group
Quality
72.02
Promoting interoperability
24
Improvement activities
40
Cost
86.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
595NVMDOptometrist
2401COMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS PHS Naihs Fort Defiance Hospital Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ntradup710652@direct.ochin.org
  • Direct secure messaging: nicole.tradup@direct.wthc.nextgenshare.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552435200000",
    "number": "1114016938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1559 WATASHEAMU RD",
            "city": "GARDNERVILLE",
            "state": "NV",
            "postal_code": "894607455",
            "telephone_number": "775-265-4215",
            "fax_number": "775-552-9840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1559 WATASHEAMU RD",
            "city": "GARDNERVILLE",
            "state": "NV",
            "postal_code": "894607455",
            "telephone_number": "928-600-7008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRADUP",
        "first_name": "NICOLE",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2019-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2401",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardnerville, NV

Sources for this page

Verify at the official NPI Registry.