DR. NICOLE TATE (MD) – Obstetrics & Gynecology Physician, NPI 1962401901

DR. NICOLE TATE (MD) is a healthcare provider. based in Lodi, California. specializing in Obstetrics & Gynecology Physician. They hold the professional credentials MD. They hold a License No. A85119 (CA). The NPI Number for DR. NICOLE TATE (MD) is 1962401901

Main info

Female
28 Years Of Experience
Accepts Medicare Assignment
Name
DR. NICOLE TATE (MD)
NPI
1962401901
Phone
(209) 465-5550
Address
PO BOX 1090
Enumeration Date
20 July 2005
Last Update Date
7 March 2023

Doctor Profile

Medical School Name
RUSH MEDICAL COLLEGE OF RUSH UNIVERSITY
Secondary Phone
5403683700
Graduation Year
1998 (28 years ago)
PAC ID
3173415999
Group Practice PAC ID
3779495858
Professional Enrollment ID
I20100820000377

Contacts

SOAP Endpoint
https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness85
Years active:20State licenses:1Other namesUpdated within 12 months

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Provider Addresses for DR. NICOLE TATE (MD)

  • PO BOX 1090

    LODI, CA 952411090

    Phone: (209) 465-5550

    Fax: (209) 334-0127

    Type: Mailing

  • South Fairmont Avenue, Lodi, San Joaquin County, California, 95241, United States

    SUITE 225

    LODI, CA 952405100

    Phone: (209) 334-4335

    Fax: (209) 334-1430

    Type: Location

  • 1201 HOSPITAL DR

    FREDERICKSBURG, VA 224018428

    Phone: (540) 368-3700

    Fax: (540) 369-3787

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-08-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100820000377IObstetrics/GynecologyVATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 95241)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3779495858View full group profile

Reviews

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Frequently asked questions

What is the standard ID for DR. NICOLE TATE (MD) in the U.S.?
In the U.S., DR. NICOLE TATE (MD) is identified by NPI 1962401901.
Should I treat DR. NICOLE TATE (MD) as an active provider?
Patients and plans typically see DR. NICOLE TATE (MD) as active in the national extract.
What does the directory say DR. NICOLE TATE (MD) does?
Insurance directories may phrase it differently, but here DR. NICOLE TATE (MD) maps to Obstetrics & Gynecology Physician. Clinical services aligned with this taxonomy classification.
Can patients visit DR. NICOLE TATE (MD) in Lodi, California?
For routing, start with Lodi, California for DR. NICOLE TATE (MD), then verify phone and hours locally.
Who maintains DR. NICOLE TATE (MD)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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