NICOLE BRANDAO REDQUEST (PA) – Physician Assistant, NPI 1578318960

NICOLE BRANDAO REDQUEST (PA) is a healthcare provider. based in Tampa, Florida. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. PA9118484 (FL). The NPI Number for NICOLE BRANDAO REDQUEST (PA) is 1578318960

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
NICOLE BRANDAO REDQUEST (PA)
NPI
1578318960
Phone
(813) 963-2020
Address
11809 N DALE MABRY HWY
Enumeration Date
19 April 2024
Last Update Date
8 April 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8139632020
Graduation Year
2023 (3 years ago)
PAC ID
7113458746
Group Practice PAC ID
8224060553
Professional Enrollment ID
I20241007001147
Address ID
FL336183505TA11809HWYX500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness75
Years active:2State licenses:2Digital endpointsOther names

9,231 PHYSICIAN ASSISTANT in FL

Provider Addresses for NICOLE BRANDAO REDQUEST (PA)

  • 11809 N DALE MABRY HWY

    TAMPA, FL 336183505

    Phone: (813) 963-2020

    Fax: (813) 265-2842

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $262.

Total Amount is formed as General ($262) + Research ($0) + Ownership ($0) = $262.

Last reported payment date: 2024-12-17 • Largest payer in this snapshot: EyePoint Pharmaceuticals US, Inc. ($129).

Total Amount

$262

General + Research + Ownership

Payments

3

Total payment records

General Amount

$262

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-17

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2024-10-07

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
I20241007001147IPhysician AssistantFLTBD

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 33618)

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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: 8224060553View full group profile
NameSpecialtyState
O P H T H A L M O L O G YFL
Physician AssistantFL
O P H T H A L M O L O G YFL
-FL
-FL
O P T O M E T R YFL
Ophthalmology, General Practice, Osteopathic Manipulative Medicine, Plastic And Reconstructive Surgery, Preventive MedicineFL
Ophthalmology, OtolaryngologyFL

Reviews

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Frequently asked questions

How is NICOLE BRANDAO REDQUEST (PA) identified in CMS data?
CMS-hosted NPPES data lists NICOLE BRANDAO REDQUEST (PA) with NPI 1578318960.
Is NICOLE BRANDAO REDQUEST (PA) still practicing?
NICOLE BRANDAO REDQUEST (PA) is currently listed as active in the public NPI registry.
What is NICOLE BRANDAO REDQUEST (PA)'s specialty?
The listing groups NICOLE BRANDAO REDQUEST (PA) with Physician Assistant. Clinical services aligned with this taxonomy classification.
Where should I expect NICOLE BRANDAO REDQUEST (PA) on a map?
Expect Tampa, Florida as a primary anchor for NICOLE BRANDAO REDQUEST (PA) unless the record lists multiple sites.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.