Chad Everett Tisdale, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2178 Issued in NC

Practice address

1729 New Hanover Medical Park Dr
Wilmington, NC 28403-5345

Phone

(910) 763-3601

Fax

(910) 763-4608

NPI assigned

Oct 27, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Optometry

Education

Indiana University - School of Optometry, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wilmington Eye, P.a.Group PAC ID 8921034323, 29 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

89.61 of 100Reported as group

Quality

91.39

Promoting interoperability

100

Improvement activities

40

Cost

73.98

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: ctisdale@wileye.intellechartdirect.net

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.

• Wilmington Eye, P.a.

  • Ophthalmology Physician
  • Wilmington, NC
  • NPI 1831280205
  Medicare reassignment Care Compare group NPD
• Neighborhood Eyecare, OD PA

  • Optometrist
  • Wilmington, NC
  • NPI 1578044509
  NPD Authorized official
• Wilmington Eye, P.a.

  • Optician
  • Wilmington, NC
  • NPI 1962566893
  NPD

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

{
    "created_epoch": "1256601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1992031934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1729 NEW HANOVER MEDICAL PARK DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284035345",
            "telephone_number": "910-763-3601",
            "fax_number": "910-763-4608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1729 NEW HANOVER MEDICAL PARK DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284035345",
            "telephone_number": "910-763-3601",
            "fax_number": "910-763-4608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISDALE",
        "first_name": "CHAD",
        "middle_name": "EVERETT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-27",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5913156",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "chad.tisdale.p1@direct.wilmeye.nextgenshare.com",
            "affiliation": "N",
            "address_1": "1729 New Hanover Medical Park Dr",
            "city": "Wilmington",
            "state": "NC",
            "country_code": "US",
            "postal_code": "284035345",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Davis Tingle
• Tinsley Surgical, PA
• Ellis A Tinsley Jr., MD
• David Glen Tipton, M.D.
• Tirzah Wellness Center, PLLC
• Katherine Laura Tison
• Sandra Ann Titka
• Kandie Tito
• Mikayla Ashlyn Tittsworth, LCMHCA
• TLC Operations, Inc

• Optometrist in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.