DR. NICOLE MARIE REDDOUT (DMD) – Oral and Maxillofacial Surgery (Dentist), NPI 1790001436
Oral and Maxillofacial Surgery (Dentist)
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
34 ORAL SURGERY in VA
Provider Addresses for DR. NICOLE MARIE REDDOUT (DMD)
112 MERIDIAN PL
SUFFOLK, VA 234353787
Phone: (702) 374-8217
Type: Mailing
1647 ADMIRAL TAUSSIG BLVD
NORFOLK, VA 235112803
Phone: (757) 953-8605
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 8 Open Payments records for all available years, with a total value of $621.
Total Amount is formed as General ($621) + Research ($0) + Ownership ($0) = $621.
Last reported payment date: 2024-03-16 • Largest payer in this snapshot: Nobel Biocare USA ($377).
Total Amount
$621
General + Research + Ownership
Payments
8
Total payment records
General Amount
$621
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-03-16
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Nobel Biocare USA | $377 |
| Envista Holdings Corporation | $244 |
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: 2023-04-07
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20230407001127 | I | Oral Surgery | VA | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99202 | New patient office or other outpatient visit, 15-29 minutes | 34 | 34 | $0 |
Insurance plans in this area (ZIP 23435)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Oral Surgery | VA | |
| Maxillofacial Surgery, Dentist | NC | |
| Oral Surgery | MO |
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