Tahoe Facial Plastic Surgery – Facial Plastic Surgery Physician, NPI 1730914433

Tahoe Facial Plastic Surgery is a healthcare provider. based in Zephyr cove, Nevada. specializing in Facial Plastic Surgery Physician. The NPI Number for Tahoe Facial Plastic Surgery is 1730914433

Main info

Organization
Name
Tahoe Facial Plastic Surgery
NPI
1730914433
Phone
(530) 721-6052
Address
PO BOX 11195
Authorized Official
DR. BENJAMIN BRADFORD CEO M.D.
Enumeration Date
4 September 2024
Last Update Date
4 September 2024
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience27
Completeness80
Years active:1State licenses:0Digital endpointsUpdated within 12 months

Provider Addresses for Tahoe Facial Plastic Surgery

  • PO BOX 11195

    ZEPHYR COVE, NV 894483195

    Phone: (530) 721-6052

    Type: Mailing

  • 1600 MEDICAL PKWY

    CARSON CITY, NV 897034625

    Phone: (530) 721-6052

    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: 2025-04-18

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
O20250418001926OClinic/Group PracticeNVTBD

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 89448)

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Reviews

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Frequently asked questions

Is there an official ID for Tahoe Facial Plastic Surgery in U.S. healthcare records?
The official identifier for Tahoe Facial Plastic Surgery is NPI 1730914433.
Active or inactive — what applies to Tahoe Facial Plastic Surgery?
You should see Tahoe Facial Plastic Surgery as active in CMS-hosted NPPES data.
What clinical focus is listed for Tahoe Facial Plastic Surgery?
At a glance, Tahoe Facial Plastic Surgery is tied to Facial Plastic Surgery Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with Tahoe Facial Plastic Surgery?
Directory geography for Tahoe Facial Plastic Surgery centers on Zephyr Cove, Nevada.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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