Nicole A Rush, OD
Individual provider Active NPI Optometrist · Bandon, OR
NPI 1467400952 · NPPES record last updated Apr 29, 2015
Key facts
- NPI
- 1467400952
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 2856ATI (OR)
- Practice address
- 1095 Alabama Ave.
Bandon, OR 97411 - Phone
- (541) 347-3622
- Fax
- (541) 347-2872
- NPI assigned
- May 5, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Pacific University - College of Optometry, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Coos Eye Centers Inc
Eye Center of Brookings LLC
Practice addresses (Care Compare)
395 2ND St SE
Bandon, OR 97411-9605
Phone (541) 347-3622
937 Chetco Ave
Suite K4005
Brookings, OR 97415-2514
Phone (541) 412-8223
Merit-based Incentive Payment System (MIPS)
- Final score
- 13.37 of 100
- Quality
- 25
- Improvement activities
- 0
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 75 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
- 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 |
|---|---|---|---|---|
| I20100428000417 | OR | Practitioner - Optometry | 5799779971 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2856ATI | OR | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eye Center of Brookings, LLC | Optometrist | Current |
Accepting new patients |
| Coos Eye Centers, Inc. | Optometrist | Current |
Accepting new patients |
| Coos Eye Centers, Inc. | Optometrist | Current |
Accepting new patients |
| Coos Eye Centers, Inc. | Optometrist | Current | Accepting new patients |
| Pacific University | Past | Accepting new patients | |
| John H Hunts MD PHD LLC | Past | Accepting new patients |
Locations
395 2nd St SE
Bandon, OR 97411
Phone (541) 347-3622
937 Chetco Ave
Ste K
Brookings, OR 97415
Phone (541) 469-6923
937 Chetco Ave
Ste K4005
Brookings, OR 97415
Phone (541) 412-8223
855 W Central Blvd
Ste A
Coquille, OR 97423
Phone (541) 396-4042
94225 4th St
Gold Beach, OR 97444
Phone (541) 247-3132
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2856ATI | OR | Yes |
Addresses
Primary practice location
1095 Alabama Ave.
Bandon, OR 97411
Mailing address
P.O. Box 956
Bandon, OR 97411
Phone (541) 347-3622
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 227958 | Medicaid | OR |
Other names
- Nicole Rush Erenfeld
Other providers in Bandon, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 29, 2015. 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.