OLIVIA TIRADO (PA) – Surgical Physician Assistant, NPI 1962703504

OLIVIA TIRADO (PA) is a healthcare provider. based in Santa cruz, California. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. PA21265 (CA). The NPI Number for OLIVIA TIRADO (PA) is 1962703504

Main info

Female
Sole Proprietor
16 Years Of Experience
Accepts Medicare Assignment
Name
OLIVIA TIRADO (PA)
NPI
1962703504
Phone
(831) 464-9962
Address
1668 DOMINICAN WAY
Enumeration Date
13 November 2010
Last Update Date
16 November 2023

Doctor Profile

Medical School Name
WESTERN UNIVERSITY OF HEALTH SCIENCES COLLEGE OF DENTAL MED
Secondary Phone
7142796088
Graduation Year
2010 (16 years ago)
PAC ID
3072788363
Group Practice PAC ID
6002729175
Professional Enrollment ID
I20111215000297
Address ID
CA928072075AN5475XAVEX500

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness85
Years active:15State licenses:1Other namesUpdated within 12 months

10,686 PHYSICIAN ASSISTANT in CA

Provider Addresses for OLIVIA TIRADO (PA)

  • 1668 DOMINICAN WAY

    SANTA CRUZ, CA 950651522

    Phone: (831) 464-9962

    Type: Location

  • 101 THE CITY DR S

    ORANGE, CA 928683201

    Phone: (714) 880-7812

    Type: Location

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: 2011-12-15

PECOS data refreshed: 2026-06-15

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
I20111215000297IPhysician AssistantCATBD

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 95065)

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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: 6002729175View full group profile
NameSpecialtyState
U R O L O G YOH
Nurse PractitionerCA
Internal MedicineCA
Internal MedicineCA
Physician AssistantCA
N E U R O L O G YCA
Internal MedicineCA
O B S T E T R I C S/ G Y N E C O L O G YCA
Family Practice, Sports MedicineCA
Internal MedicineNY

Reviews

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Frequently asked questions

What NPI should I save for OLIVIA TIRADO (PA)?
Save NPI 1962703504 if you need a stable reference for OLIVIA TIRADO (PA).
Is OLIVIA TIRADO (PA) active in the national directory?
OLIVIA TIRADO (PA)'s public NPI profile is in an active state.
Does OLIVIA TIRADO (PA) list a primary specialty?
If you are matching referrals, note Surgical Physician Assistant for OLIVIA TIRADO (PA). Clinical services aligned with this taxonomy classification.
Where is OLIVIA TIRADO (PA)'s primary listing?
We display Santa Cruz, California because that is what the record indicates for OLIVIA TIRADO (PA).
Is OLIVIA TIRADO (PA) a real provider?
This page reflects official NPPES data for NPI 1962703504. Always confirm identity and privileges with the practice and licensing boards.

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