NPIMap

Individual provider Active NPI

Tina Nelson, MD

  • Diagnostic Radiology Physician
  • Lebanon, NH
National Provider Identifier
1639182322
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
10541 Issued in NH
Practice address
1 Medical Center Dr
Lebanon, NH 03756-1000
Phone
(603) 650-4477
Fax
(603) 650-5455
NPI assigned
Aug 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 10541 NH Primary

Addresses

Primary practice location

1 Medical Center Dr
Lebanon, NH 03756-1000

Mailing address

PO Box 224
Spofford, NH 03462-0224

Other identifiers 2

IdentifierTypeStateIssuer
30200179MedicaidNH
0RE5264MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, VT, MA3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20031126000648 NH Practitioner - Diagnostic Radiology 2264337682 Reassigns benefits to 2 organizations
I20161018001024 VT Practitioner - Diagnostic Radiology 2264337682 Reassigns benefits to 1 organization
I20210330000105 MA Practitioner - Diagnostic Radiology 2264337682 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dartmouth-Hitchcock ClinicGroup PAC ID 4183537509, 1,445 clinicians
Henry Heywood Memorial HospitalGroup PAC ID 1658262605, 116 clinicians
Radiology Associates of Keene PCGroup PAC ID 5698871960, 5 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Lebanon, NH 03756-1000
Phone (603) 650-5000

16 Hospital Rd
Plymouth, NH 03264-1126
Phone 6035361120256

17 Belmont Ave
Brattleboro, VT 05301-7601
Phone (802) 257-0341

2033 Main St
Athol, MA 01331-3535
Phone (978) 249-3511

242 Green St
Gardner, MA 01440-1336
Phone (978) 632-3420

580 Court St
Keene, NH 03431-1718
Phone (603) 354-6580

590 Court St
Keene, NH 03431-1719
Phone (603) 354-5400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
92.5 of 100Reported as group
Quality
85
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Heywood Memorial Hospital CurrentSince Jul 1, 2021 Accepting new patients
Radiology Associates of Keene PC Diagnostic Radiology CurrentSince Jan 1, 2007 Accepting new patients
Dartmouth-Hitchcock Clinic Diagnostic Radiology CurrentSince Mar 4, 2022 Accepting new patients
Athol Memorial Hospital Incorporated CurrentSince Jul 1, 2021 Accepting new patients
Henry Heywood Memorial Hospital CurrentSince Jul 1, 2021 Accepting new patients
Brattleboro Memorial Hospital PastSince Aug 1, 2016 Accepting new patients

Locations

2033 Main St
Athol, MA 01331
Phone (978) 249-1295

242 Green St
Gardner, MA 01440
Phone (978) 258-4734

580 Court St
Keene, NH 03431
Phone (603) 354-5454

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

16 Hospital Rd
Plymouth, NH 03264
Phone (603) 238-2229

17 Belmont Ave
Brattleboro, VT 05301
Phone (802) 257-8360

53 Fairview St
Brattleboro, VT 05301
Phone (802) 251-8455

25 Ridgewood Rd
Springfield, VT 05156
Phone (780) 281-9593

Interoperability endpoints

  • Direct secure messaging: tnelson86292@direct.dartmouth-hitchcock.org
  • FHIR API: https://fhir-myrecord.cerner.com/r4/d9dc001d-1bc5-42f9-bd4d-eb79208fd32a/

Organizations & group practices 6

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 8

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": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639182322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 224",
            "city": "SPOFFORD",
            "state": "NH",
            "postal_code": "034620224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-650-4477",
            "fax_number": "603-650-5455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "TINA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NH",
            "license": "10541",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30200179",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0RE5264",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.