NPIMap

Individual provider Active NPI

Susan J Anderson-Nelson, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Wheaton, IL
National Provider Identifier
1013904986
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
036079057 Issued in IL
Practice address
2015 N Main St
Wheaton, IL 60187-3152
Phone
(630) 668-8250
Fax
(630) 668-8916
NPI assigned
Oct 5, 2005
Last updated
Aug 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 36-079057 IL
Retina Specialist (Ophthalmology) Physician 207WX0107X 036079057 IL Primary

Addresses

Primary practice location

2015 N Main St
Wheaton, IL 60187-3152

Mailing address

2015 N Main St
Wheaton, IL 60187-3152
Phone (630) 668-8250

Other identifiers 2

IdentifierTypeStateIssuer
180012234OtherILRR MEDICARE
036079057MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100206000149 IL Practitioner - Ophthalmology 2365425451 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Rush Medical College of Rush University, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wheaton Eye Clinic LTDGroup PAC ID 2860475944, 44 clinicians
Cook CountyGroup PAC ID 2860398088, 770 clinicians

Practice addresses (Care Compare)

2015 N Main St
Wheaton, IL 60187-3152
Phone (630) 668-8250

500 E 51St St
Chicago, IL 60615-2494
Phone (312) 572-2000

604 Raymond Dr
Naperville, IL 60563-9788
Phone (630) 668-8250

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.11 of 100Reported as group
Quality
74.7
Promoting interoperability
100
Improvement activities
40
Cost
85.45

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
36-079057ILMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lawndale Christian Health Center Current Accepting new patients
Lawndale Christian Health Center CurrentSince Aug 20, 2017 Accepting new patients
Lawndale Christian Health Center CurrentSince Aug 20, 2017 Accepting new patients
Cook County Current Accepting new patients
Wheaton Eye Clinic LTD Ophthalmology CurrentSince Jan 1, 1987 Accepting new patients
Lawndale Christian Health Center Current Accepting new patients
Wheaton Eye Clinic LTD Ophthalmology CurrentSince Jan 1, 1987 Accepting new patients
Cook County CurrentSince Nov 4, 2010 Accepting new patients
Cook County CurrentSince Nov 4, 2010 Accepting new patients
Wheaton Eye Clinic LTD Ophthalmology Past Accepting new patients

Locations

1900 W Polk St
Ste 220C
Chicago, IL 60612

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

3860 W Ogden Ave
Chicago, IL 60623
Phone (872) 588-3000

4696 Paysphere Cir
Chicago, IL 60674

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

908 N Elm St
Ste 115
Hinsdale, IL 60521
Phone (630) 321-9429

604 Raymond Dr
Naperville, IL 60563
Phone (630) 668-8250

2015 N Main St
Wheaton, IL 60187
Phone (630) 665-3690

Interoperability endpoints

  • Direct secure messaging: sanderson3@direct.ccprovider.org
  • Direct secure messaging: sandersonnelson721211@direct.ochin.org

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 27

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 27

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1013904986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 N MAIN ST",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601873152",
            "telephone_number": "630-668-8250",
            "fax_number": "630-668-8916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 N MAIN ST",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601873152",
            "telephone_number": "630-668-8250",
            "fax_number": "630-668-8916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON-NELSON",
        "first_name": "SUSAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-05",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "36-079057",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "IL",
            "license": "036079057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "180012234",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036079057",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

Verify at the official NPI Registry.