NPIMap

Individual provider Active NPI

Nicole Elizabeth Tucker, DO

  • Family Medicine Physician
  • Albany, OR
National Provider Identifier
1952806291
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO211584 Issued in OR
Practice address
631 Elm St SW Ste 200&205
Albany, OR 97321-1952
Phone
(541) 812-5020
NPI assigned
Mar 28, 2018
Last updated
Aug 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X DO211584 OR Primary

Addresses

Primary practice location

631 Elm St SW Ste 200&205
Albany, OR 97321-1952

Mailing address

PO Box 2792
Corvallis, OR 97339-2792

Other practice location 1

123 Hendersonville Rd
Asheville, NC 28803-2868
Phone (828) 257-4730

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ntucker240505@samhealth.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20220824000540 OR Practitioner - Family Practice 2860749850 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Rocky Vista University College of Osteopathic Med, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Albany General HospitalGroup PAC ID 9931097987, 191 clinicians

Practice addresses (Care Compare)

1046 6TH Ave SW
Albany, OR 97321-1916
Phone (541) 812-4000

3600 NW Samaritan Dr
Corvallis, OR 97330-3737

631 Elm St SW
Albany, OR 97321-1952

705 Elm St SW
Suite 200
Albany, OR 97321-1957
Phone (541) 812-4850

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.37 of 100Reported as group
Quality
92.31
Promoting interoperability
100
Improvement activities
40
Cost
80.9

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO211584ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Albany General Hospital Current Accepting new patients
Albany General Hospital Family Medicine CurrentSince Sep 1, 2022 Accepting new patients
Good Samaritan Hospital Corvallis CurrentSince Sep 1, 2022 Accepting new patients
Mid-Valley Healthcare Inc CurrentSince Aug 1, 2023 Accepting new patients
Albany General Hospital CurrentSince Aug 18, 2024 Accepting new patients
Good Samaritan Hospital Corvallis CurrentSince Sep 1, 2022 Accepting new patients
Mid-Valley Healthcare Inc CurrentSince Aug 1, 2023 Accepting new patients
Albany General Hospital Family Medicine CurrentSince Sep 1, 2022 Accepting new patients
Good Samaritan Hospital Corvallis Current Accepting new patients

Locations

631 Elm St SW
Ste 200205
Albany, OR 97321
Phone (541) 812-5020

631 Elm St SW
Ste 205
Albany, OR 97321
Phone (541) 812-5020

705 Elm St SW
Ste 200
Albany, OR 97321
Phone (541) 812-4850

3600 NW Samaritan Dr
Ste 227
Corvallis, OR 97330
Phone (541) 768-1261

815 NW 9th St
Ste 215
Corvallis, OR 97330
Phone (541) 768-1888

325 Park St
Lebanon, OR 97355
Phone (541) 451-7200

Organizations & group practices 9

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 38

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

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1522195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1952806291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2792",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973392792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 ELM ST SW STE 200&205",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973211952",
            "telephone_number": "541-812-5020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "123 Hendersonville Rd",
            "address_purpose": "LOCATION",
            "city": "Asheville",
            "state": "NC",
            "postal_code": "288032868",
            "country_code": "US",
            "telephone_number": "828-257-4730",
            "fax_number": "828-257-4738",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "NICOLE",
        "middle_name": "ELIZABETH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-28",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO211584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ntucker240505@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "631 Elm St SW Ste 200&205",
            "city": "Albany",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973211952",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Albany, OR

Sources for this page

Verify at the official NPI Registry.