Individual provider Active NPI

Paul A. Tachau, O.D.

  • Optometrist
  • Santa Fe, NM
National Provider Identifier
1649384710
Registry record updated Oct 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
325 Issued in NM
Practice address
1409 Luisa St
Suite D
Santa Fe, NM 87505-7002
Phone
(505) 984-8989
Fax
(505) 984-8892
NPI assigned
Aug 18, 2006
Last updated
Oct 1, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 325 NM Primary

Addresses

Primary practice location

1409 Luisa St
Suite D
Santa Fe, NM 87505-7002

Mailing address

1409 Luisa St
Suite D
Santa Fe, NM 87505-7002
Phone (505) 984-8989

Other identifiers 5

IdentifierTypeStateIssuer
201009817OtherNMPRESBYTERIAN
9921367OtherNMCIGNA
NM01P505OtherNMBLUE CROSS BLUE SHIELD
00NM01P398OtherNMBLUE CROSS BLUE SHIELD
201009816OtherNMPRESBYTERIAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20040423000468 NM Practitioner - Optometry 9931195286 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Accent on Vision, Santa Fe LLCGroup PAC ID 3476534686, 4 clinicians

Practice addresses (Care Compare)

1645 Galisteo St
Santa Fe, NM 87505-4749
Phone (505) 984-8989

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Accent on Vision, Santa Fe LLC Optometrist CurrentSince Dec 30, 1997 Accepting new patients
Ashley J Pulis OD LLC PastSince Sep 2, 2003 Accepting new patients

Locations

1409 Luisa St
Ste D
Santa Fe, NM 87505
Phone (505) 984-8989

1645 Galisteo St
Santa Fe, NM 87505
Phone (505) 984-0694

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, 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": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380585600000",
    "number": "1649384710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 LUISA ST",
            "address_2": "SUITE D",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057002",
            "telephone_number": "505-984-8989",
            "fax_number": "505-984-8892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 LUISA ST",
            "address_2": "SUITE D",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057002",
            "telephone_number": "505-984-8989",
            "fax_number": "505-984-8892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACHAU",
        "first_name": "PAUL",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2013-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NM",
            "license": "325",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESBYTERIAN",
            "identifier": "201009817",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "9921367",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "NM01P505",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "00NM01P398",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESBYTERIAN",
            "identifier": "201009816",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

Verify at the official NPI Registry.