Kristin Nelson, OD, IACMM

Primary specialty

OptometristTaxonomy code 152W00000X

License

046011423 Issued in IL

Practice address

11390 Summerlin Square Dr
Fort Myers Beach, FL 33931-5300

Phone

(239) 343-8880

Fax

(239) 343-4213

NPI assigned

May 29, 2020

Last updated

Oct 30, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Optometry

Education

Southern College of Optometry, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optimal Vision Optometry LLCGroup PAC ID 2860815644, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: knelson375040@direct.leememorial.org

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.

• Optimal Vision Optometry LLC

  dba Riverside Family Eye Care

  • Optometrist
  • Fort Myers, FL
  • NPI 1609498856
  Medicare reassignment Care Compare group NPD
• Lee Health System Inc

  • Internal Medicine Physician
  • Fort Myers, FL
  • NPI 1942058557
  Medicare reassignment NPD
• Lee Memorial Health System

  • Internal Medicine Physician
  • Fort Myers, FL
  • NPI 1992873319
  Medicare reassignment NPD
• Lee Health System Inc

  dba Lee Health Specialty Pharmacy

  • Community/Retail Pharmacy
  • Bonita Springs, FL
  • NPI 1699510925
  NPD
• Lee Memorial Health System

  dba LCH-Golisano Peds PC Bayshore

  • Federally Qualified Health Center (FQHC)
  • Port Charlotte, FL
  • NPI 1255171765
  NPD

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

{
    "created_epoch": "1590710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1447874060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-8880",
            "fax_number": "239-343-4213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11390 SUMMERLIN SQUARE DR",
            "city": "FORT MYERS BEACH",
            "state": "FL",
            "postal_code": "339315300",
            "telephone_number": "239-343-8880",
            "fax_number": "239-343-4213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "KRISTIN",
        "name_prefix": "Dr.",
        "credential": "OD, IACMM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-29",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC6206",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046011423",
            "primary": true
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "IL",
            "license": "046011423",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "IL",
            "license": "0466011423",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119758500",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "knelson375040@Direct.leememorial.org",
            "affiliation": "Y",
            "affiliationName": "LEE HEALTH SYSTEM INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2776 Cleveland Ave",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339015864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ronald Thomas Markby
• Mariene Martinez Mesa
• Lauren McFalls, RN
• David Louis McKay, DDS
• Kayla Nicole Michalik, DPT
• Margarita Nemirovsky, PHARMD
• Illya Y. Novikov, DOCTOR OF DENTISTRY
• Doris Oropesa Carrillo
• Carla Jeannette Osigian Probst, M.D.
• Gregory Palmer, DPT

• Optometrist in Fort Myers Beach, FL
• Providers in Fort Myers Beach, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.