Individual provider Active NPI

Tad C Schrader, PA-C

  • Physician Assistant
  • Spartanburg, SC
National Provider Identifier
1366961872
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0005499 Issued in CO
Practice address
1330 Boiling Springs Rd Ste 1600
Spartanburg, SC 29303-4219
Phone
(864) 582-6396
Fax
(864) 582-1608
NPI assigned
Sep 15, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.0005499 CO Primary

Addresses

Primary practice location

1330 Boiling Springs Rd Ste 1600
Spartanburg, SC 29303-4219

Mailing address

PO Box 751649
Charlotte, NC 28275-1649
Phone (843) 789-1620

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20171109003277 SC Practitioner - Physician Assistant 0840556684 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

115 Deacon Tiller CT
Duncan, SC 29334-8880
Phone (864) 582-6396

1330 Boiling Springs Rd
Suite 1600
Spartanburg, SC 29303-4219
Phone (864) 582-6396

220 Roper Mountain Rd Ext
Greenville, SC 29615-4886
Phone (864) 582-6396

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Orthopaedic and Neurosurgical Associates CurrentSince Dec 5, 2024 Accepting new patients
Carolina Orthopaedic and Neurosurgical Associates CurrentSince Dec 5, 2024 Accepting new patients

Locations

115 Deacon Tiller Ct
Duncan, SC 29334
Phone (864) 582-6396

220 Roper Mountain Road Ext
Greenville, SC 29615
Phone (864) 242-1163

1330 Boiling Springs Rd
Ste 1600
Spartanburg, SC 29303
Phone (864) 582-6396

1330 Boiling Springs Rd
Ste 1600B
Spartanburg, SC 29303
Phone (864) 582-0019

Interoperability endpoints

  • Direct secure messaging: tad.schrader.1@26879.direct.athenahealth.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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1505433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1366961872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751649",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751649",
            "telephone_number": "843-789-1620",
            "fax_number": "843-724-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 BOILING SPRINGS RD STE 1600",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293034219",
            "telephone_number": "864-582-6396",
            "fax_number": "864-582-1608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHRADER",
        "first_name": "TAD",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-15",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0005499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.