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DR. NADEZDA A TRETYAKOVA MD
NPI 1477832590
General Practice in Acoma, NM

Active since August 07, 2011PECOS Enrolled
80 B VETERANS BLVD, I-40, EXIT 102, ACOMA, NM 87034(505) 552-5300(505) 552-5828 Get Directions Write a Review

NPPES record last updated: July 9, 2015. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Nadezda A Tretyakova Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. NADEZDA A TRETYAKOVA MD (NPI 1477832590) is an individual general practice provider in Acoma, New Mexico, licensed in New Mexico (MD2013-0883) and active in the NPI registry since August 2011. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1477832590
Entity TypeIndividualFemale
Primary Taxonomy208D00000X
Provider Legal NameDR. NADEZDA A TRETYAKOVACredential: MD
Location Address80 B VETERANS BLVD, I-40, EXIT 102Acoma, NM 87034
Mailing AddressPo Box 130San Fidel, NM 87049-0130 · (505) 552-5300 · Fax (505) 552-5828
Phone(505) 552-5300
Fax(505) 552-5828
Sole ProprietorNo
Enumeration DateAugust 7, 2011
Last NPPES UpdateJuly 9, 2015
✔ NPI 1477832590 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in NM · MD2013-0883
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
80 B VETERANS BLVD, Acoma, NM 87034
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Other Identifiers 2

MedicaidH3451NM
Medicare OSCAR/certification320070NM

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Nadezda A Tretyakova Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Nadezda Tretyakova reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Emergency Staffing Solutions Inc
850 mi
Emergency Medicine
240 HIGHLAND DR
Many, LA 71449
  • Reassigned Medicare billing, New Mexico enrollment
  • 152 clinicians in this Medicare group
NPI 1477590974 (318) 256-5691
Ess Hospitalist LLC
905 mi
Hospitalist
1015 UNITY RD
Crossett, AR 71635
  • Reassigned Medicare billing, New Mexico enrollment
  • 114 clinicians in this Medicare group
NPI 1881967305 (866) 931-8882

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. GEORGE R KIRACOFE M.D.
Family Medicine
80 B VETERANS BLVD, I-40, EXIT 102
ACOMA, NM 87034
Cibola County (505) 552-5300
MS. HLENGIWE LINDANI SIBANDA FNP
Nurse Practitioner (Family)
80 B VETERANS BLVD
ACOMA, NM 87034
Cibola County (505) 552-5300
MICHELLE F DUBUISSON FNP-C
Nurse Practitioner (Family)
80 B VETERANS BLVD
ACOMA, NM 87034
Cibola County (505) 552-5300
DR. RYAN HODNICK DO
Emergency Medicine
80 B VETERANS BLVD
PUEBLO OF ACOMA, NM 87034
Cibola County (505) 552-5300
BRADLEY A WALKER MD
Emergency Medicine
80 B VETERANS BLVD
ACOMA, NM 87034
Cibola County (505) 552-5300
DR. RICHARD M KAUT MD
Emergency Medicine
80 B VETERANS BLVD
ACOMA, NM 87034
Cibola County (505) 552-5300
PATRICIA A MONROE CNP
Nurse Practitioner (Family)
80 B VETERANS BLVD
ACOMA, NM 87034
Cibola County (505) 552-5300
DEAN H HATTAN OD
Optometrist
80 B VETERANS BLVD, I-40, EXIT 102
ACOMA, NM 87034
Cibola County (505) 552-5300

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nadezda Tretyakova's NPI number?

The NPI number for Nadezda Tretyakova is 1477832590. It was assigned to this individual provider in the NPPES registry on August 7, 2011.

Where is Nadezda Tretyakova located?

Nadezda Tretyakova practices at 80 B Veterans Blvd I-40, Exit 102, Acoma, NM 87034. The listed phone number is (505) 552-5300.

What is Nadezda Tretyakova's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Nadezda Tretyakova enrolled in Medicare?

Yes. Nadezda Tretyakova is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Nadezda Tretyakova's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nadezda Tretyakova reassigns Medicare benefits to 2 organizations: Emergency Staffing Solutions Inc (Many, LA) and Ess Hospitalist LLC (Crossett, AR). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Nadezda Tretyakova's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Nadezda Tretyakova was last updated on July 9, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.