Individual provider Active NPI

Olivia Vinup, AU.D.

  • Audiologist
  • South Lake Tahoe, CA
National Provider Identifier
1972485118
Registry record updated Jul 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AU4045 Issued in CA
Practice address
2074 Lake Tahoe Blvd Ste 9
South Lake Tahoe, CA 96150-6417
Phone
(530) 537-3344
NPI assigned
Jul 21, 2025
Last updated
Jul 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AU4045 CA Primary

Addresses

Primary practice location

2074 Lake Tahoe Blvd Ste 9
South Lake Tahoe, CA 96150-6417

Mailing address

964 Shakori Dr
South Lake Tahoe, CA 96150-4163
Phone (928) 287-0977

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250903002874 CA Practitioner - Qualified Audiologist 5597267211 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
At Still Un of HLTH Sciences, Col of Osteo Med, Mesa, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tahoe Family Hearing Clinic, PCGroup PAC ID 2567838006, 2 clinicians

Practice addresses (Care Compare)

2074 Lake Tahoe Blvd
Suite 9
South Lake Tahoe, CA 96150-6417
Phone (530) 318-5922

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AU4045CAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Tahoe Family Hearing Clinic, PC Audiologist CurrentSince Aug 8, 2025 Accepting new patients

Locations

2074 Lake Tahoe Blvd
Ste 9
South Lake Tahoe, CA 96150
Phone (530) 318-5922

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": "1753056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1972485118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "964 SHAKORI DR",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961504163",
            "telephone_number": "928-287-0977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2074 LAKE TAHOE BLVD STE 9",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961506417",
            "telephone_number": "530-537-3344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINUP",
        "first_name": "OLIVIA",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-21",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CA",
            "license": "AU4045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Lake Tahoe, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.