Active NPI
Nicholas Robert Rader, M.D.
- Ophthalmology Physician
- Greenwood, IN
National Provider Identifier
1912990144
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 01026346A
- Practice address
- 30 N Emerson Ave
Greenwood, IN 46143-8895 - Phone
- (317) 881-3937
- Fax
- (317) 887-4008
- NPI assigned
- Aug 23, 2005
- Last updated
- Feb 1, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 01026346A | IN | Primary |
Addresses
Primary practice location
30 N Emerson Ave
Greenwood, IN 46143-8895
Mailing address
30 N Emerson Ave
Greenwood, IN 46143-8895
Phone (317) 881-3937
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100153400 | Medicaid | IN | |
| 000000011607 | Other | IN | SENIOR SMART CHOICE |
| 0004361323 | Other | IN | AETNA |
| 180044026 | Other | IN | RAILROAD MEDICARE |
| 154807 | Other | IN | COLE VISION |
| 000000011607 | Other | IN | MPLAN |
| 000000214825 | Other | IN | BCBS |
| 352129520 | Other | IN | UNITED MINE WORKERS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01026346A | IN | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Major Hospital | Ophthalmology | Past | Accepting new patients |
Organizations & group practices 1
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": "1124755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264982400000",
"number": "1912990144",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 N EMERSON AVE",
"city": "GREENWOOD",
"state": "IN",
"postal_code": "461438895",
"telephone_number": "317-881-3937",
"fax_number": "317-887-4008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 N EMERSON AVE",
"city": "GREENWOOD",
"state": "IN",
"postal_code": "461438895",
"telephone_number": "317-881-3937",
"fax_number": "317-887-4008"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RADER",
"first_name": "NICHOLAS",
"middle_name": "ROBERT",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-23",
"last_updated": "2010-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "IN",
"license": "01026346A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100153400",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SENIOR SMART CHOICE",
"identifier": "000000011607",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "0004361323",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "180044026",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COLE VISION",
"identifier": "154807",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MPLAN",
"identifier": "000000011607",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "000000214825",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED MINE WORKERS",
"identifier": "352129520",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greenwood, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.