NPIMap

Individual provider Active NPI

Nicholas Stephen Andrade, M.D.

  • Neurological Surgery Physician
  • Tyler, TX
National Provider Identifier
1497919310
Registry record updated Jul 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
Q5142 Issued in TX
Practice address
700 Olympic Plaza Cir Ste 850
Tyler, TX 75701-1955
Phone
(903) 590-8012
NPI assigned
Jul 10, 2008
Last updated
Jul 20, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X Q5142 TX Primary

Addresses

Primary practice location

700 Olympic Plaza Cir Ste 850
Tyler, TX 75701-1955

Mailing address

700 Olympic Plaza Cir Ste 850
Tyler, TX 75701-1955

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150810000960 TX Practitioner - Neurosurgery 2163736844 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
University of Texas Southwestern Medical School at Dallas, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

910 E Houston St
330 Christus Trinity Clinic
Tyler, TX 75702-8368
Phone (903) 525-7995

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion151
Laminectomy or laminotomy (partial removal of spine bones)61

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
Q5142TXMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas Neurological Surgery CurrentSince Jul 31, 2017 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Jul 31, 2017 Accepting new patients
Mother Frances Hospital Regional Health Care Center Past Accepting new patients

Locations

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

910 E Houston St
Ste 330
Tyler, TX 75702
Phone (903) 510-8718

Interoperability endpoints

  • Direct secure messaging: nandrade110543@christushealth.direct-ci.net

Organizations & group practices 3

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.

Hospital & facility affiliations 10

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": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437350400000",
    "number": "1497919310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 OLYMPIC PLAZA CIR STE 850",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 OLYMPIC PLAZA CIR STE 850",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011955",
            "telephone_number": "903-590-8012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRADE",
        "first_name": "NICHOLAS",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-10",
        "last_updated": "2015-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "TX",
            "license": "Q5142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.