Individual provider Active NPI

Nikalous Tolman, D.O

  • Optometrist
  • Laramie, WY
National Provider Identifier
1487107280
Registry record updated Jul 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
409T Issued in WY
Practice address
418 S 5TH St
Laramie, WY 82070-3733
Phone
(307) 745-8554
NPI assigned
Jul 27, 2016
Last updated
Jul 27, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 409T WY Primary

Addresses

Primary practice location

418 S 5TH St
Laramie, WY 82070-3733

Mailing address

418 S 5TH St
Laramie, WY 82070-3733
Phone (307) 745-8554

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
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
I20170223000745 WY Practitioner - Optometry 5597049346 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Albany Eye Care, LLCGroup PAC ID 8123001351, 2 clinicians

Practice addresses (Care Compare)

418 S 5TH St
Laramie, WY 82070-3733
Phone (370) 745-8554

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery32

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
409TWYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Albany Eye Care, LLC Optometrist CurrentSince Jan 10, 2017 Accepting new patients
Precision Spinal Care LLC PastSince Jan 10, 2017 Accepting new patients

Locations

418 S 5th St
Laramie, WY 82070
Phone (307) 745-8554

Organizations & group practices 2

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": "1469577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469577600000",
    "number": "1487107280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 S 5TH ST",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820703733",
            "telephone_number": "307-745-8554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 S 5TH ST",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820703733",
            "telephone_number": "307-745-8554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLMAN",
        "first_name": "NIKALOUS",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-27",
        "last_updated": "2016-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WY",
            "license": "409T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laramie, WY

Sources for this page

Verify at the official NPI Registry.