Individual provider Active NPI

Nicole Leo, OD

  • Optometrist
  • Derry, NH
National Provider Identifier
1295336030
Registry record updated Dec 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2761 Issued in MD
Practice address
6 Tsienneto Rd Ste 101
Derry, NH 03038-1584
Phone
(603) 434-4193
NPI assigned
Nov 6, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 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 2761 MD Primary

Addresses

Primary practice location

6 Tsienneto Rd Ste 101
Derry, NH 03038-1584

Mailing address

PO Box 250
Topsfield, MA 01983-0350

Other practice location 1

166 West St
Keene, NH 03431-3362
Phone (603) 352-7803

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20210716001011 NH Practitioner - Optometry 0345642054 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spindel Eye Associates PCGroup PAC ID 4880676659, 12 clinicians

Practice addresses (Care Compare)

6 Tsienneto Rd
Suite 101
Derry, NH 03038-1584
Phone (603) 434-4193

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2761MDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Spindel Eye Associates PC CurrentSince Sep 1, 2021 Accepting new patients

Locations

166 S River Rd
Ste 100
Bedford, NH 03110

6 Tsienneto Rd
Ste 101
Derry, NH 03038
Phone (603) 434-4193

50 Michels Way
Unit 104
Londonderry, NH 03053

6 Tsienneto Rd
Londonderry, NH 03038
Phone (603) 421-9959

6 Old Fremont Road Ext
Ste 1
Raymond, NH 03077

49 Range Rd
Windham, NH 03087
Phone (603) 421-2460

49 Range Rd
Ste 106
Windham, NH 03087
Phone (603) 434-4193

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1604620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1295336030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 250",
            "city": "TOPSFIELD",
            "state": "MA",
            "postal_code": "019830350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 TSIENNETO RD STE 101",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "030381584",
            "telephone_number": "603-434-4193"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "166 West St",
            "address_purpose": "LOCATION",
            "city": "Keene",
            "state": "NH",
            "postal_code": "034313362",
            "country_code": "US",
            "telephone_number": "603-352-7803",
            "fax_number": "603-354-3165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEO",
        "first_name": "NICOLE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-06",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "2761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Derry, NH

Sources for this page

Verify at the official NPI Registry.