Individual provider Active NPI

Charles A Nassauer, O.D.

  • Optometrist
  • Slidell, LA
National Provider Identifier
1275677783
Registry record updated Jul 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
919183T Issued in LA
Practice address
170 Northshore Blvd Ste C
Slidell, LA 70460-6849
Phone
(985) 641-1228
Fax
(985) 643-1359
NPI assigned
Feb 16, 2007
Last updated
Jul 12, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 919183T LA Primary

Addresses

Primary practice location

170 Northshore Blvd Ste C
Slidell, LA 70460-6849

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

Other identifiers 5

IdentifierTypeStateIssuer
1380873MedicaidLA
MN4126858OtherLAHUMANA ID
721158167OtherLATAX PAY ID
LA99183OtherLAVBA ID
LA9183OtherLAEYE MED ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090217000749 LA Practitioner - Optometry 1456416973 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1844 N Causeway Blvd
Mandeville, LA 70471-3112
Phone (985) 327-2230

601 Georgia Ave
Bogalusa, LA 70427-3909
Phone (985) 732-4900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
919LAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Artis Beatty a Professional Optometry Corporation Optometrist CurrentSince Aug 29, 2022 Accepting new patients
Artis Beatty a Professional Optometry Corporation Optometrist CurrentSince Aug 29, 2022 Accepting new patients
Artis Beatty a Professional Optometry Corporation Optometrist Current Accepting new patients
Can, Inc. Optometrist CurrentSince Apr 14, 1998 Accepting new patients
Can, Inc. Optometrist Past Accepting new patients
Audubon Eye Institute PastSince Sep 1, 2008 Accepting new patients

Locations

601 Georgia Ave
Bogalusa, LA 70427
Phone (985) 249-7833

13322 Highway 90
Ste L
Boutte, LA 70039
Phone (985) 785-8484

1844 N Causeway Blvd
Mandeville, LA 70471
Phone (985) 327-2230

3200 Severn Ave
Metairie, LA 70002
Phone (504) 541-9025

170 Northshore Blvd
Ste C
Slidell, LA 70460
Phone (985) 641-1228

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Interoperability endpoints

  • Direct secure messaging: cnassauer026631@myeyedr.emadirect.md

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1275677783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 NORTHSHORE BLVD STE C",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704606849",
            "telephone_number": "985-641-1228",
            "fax_number": "985-643-1359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASSAUER",
        "first_name": "CHARLES",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "LA",
            "license": "919183T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1380873",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA ID",
            "identifier": "MN4126858",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX PAY ID",
            "identifier": "721158167",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VBA ID",
            "identifier": "LA99183",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYE MED ID",
            "identifier": "LA9183",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Slidell, LA

Sources for this page

Verify at the official NPI Registry.