Nicole Ann Solem, OD
Individual provider Active NPI Optometrist · Plymouth, MN
NPI 1073181574 · NPPES record last updated Jul 21, 2023
Key facts
- NPI
- 1073181574
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- MS8065496 (MN)
- Practice address
- 4455 Highway 169 N
Plymouth, MN 55442-2897 - Phone
- (763) 559-7358
- NPI assigned
- Jun 12, 2021
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Don Sealock OD PA
Practice addresses (Care Compare)
4455 Hwy 169 N
Plymouth, MN 55442
Phone (763) 746-3391
Merit-based Incentive Payment System (MIPS)
- Final score
- 92.01 of 100
- Quality
- 84.02
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231121000406 | MN | Practitioner - Optometry | 8921401134 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hometown Eye Care, Inc | Optometrist | Past |
Accepting new patients |
| Don Sealock, O.D., P.a. | Past |
Accepting new patients |
Interoperability endpoints
- nicole.solem.p1@direct.eyecarepartners.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 046011514 | IL | |
| Optometrist | 152W00000X | MS8065496 | MN | Yes |
Addresses
Primary practice location
4455 Highway 169 N
Plymouth, MN 55442-2897
Mailing address
PO Box 604
Buffalo, MN 55313-0604
Phone (218) 340-8411
Other practice location 1
645 N Michigan Ave Ste 210
Chicago, IL 60611-2825
Phone (312) 787-2020
Other practice location 2
141 W Jackson Blvd
Chicago, IL 60604-2992
Phone (312) 427-9555
Other names
- Nicole Purrier
Other providers in Plymouth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.