Nicole Corsiatti, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046011224 Issued in IL

Practice address

310 S Weber Rd
Bolingbrook, IL 60490-5500

Phone

(630) 771-0600

Fax

(815) 724-1505

NPI assigned

Jun 18, 2018

Last updated

Nov 4, 2021By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Illinois College of Optometry at Chicago, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Myeyedr Optometry of Illinois LLCGroup PAC ID 3577869965, 66 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ncorsiatti015314@myeyedr.emadirect.md

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.

• Myeyedr Optometry of Illinois, LLC

  dba MyEyeDr.

  • Optometrist
  • Chicago, IL
  • NPI 1245695378
  Medicare reassignment Care Compare group NPD
• George Albert Roebuck, O.D.

  • Optometrist
  • Morris, IL
  • NPI 1720094287
  Medicare reassignment
• Myeyedr Optometry of Illinois, LLC

  • Optometrist
  • Chicago, IL
  • NPI 1154297752
  NPD
• James K. Cutler O.D. & Associates, P.C.

  • Optometrist
  • Joliet, IL
  • NPI 1447450887
  NPD (past)

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

{
    "created_epoch": "1529280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1538653233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 S WEBER RD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604905500",
            "telephone_number": "630-771-0600",
            "fax_number": "815-724-1505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORSIATTI",
        "first_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-18",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046011224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Concave Tech Consulting Inc
• Nicholas J Cone, D.C.
• Debra Conley
• Lisa Cook, DRPH, LCPC, LPCC
• Marlys Cooper, PHARMD
• Marianne L Costales-Roman, LCSW
• Costco Wholesale Corporation (Costco Hearing Aid #1088)
• Costco Wholesale Corporation
• Costco Wholesale Corporation (Costco Optical #1088)
• Cary Ann Cottingham Edgerton, LSW

• Optometrist in Bolingbrook, IL
• Providers in Bolingbrook, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2021; 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.