Individual provider Active NPI

Andrew John Nelson, MD

  • Ophthalmology Physician
  • Sacramento, CA
National Provider Identifier
1558990515
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A177534 Issued in CA
Practice address
4860 Y St
Sacramento, CA 95817-2307
Phone
(916) 734-6060
NPI assigned
Apr 2, 2020
Last updated
Oct 1, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X A177534 CA Primary

Addresses

Primary practice location

4860 Y St
Sacramento, CA 95817-2307

Mailing address

4860 Y St
Sacramento, CA 95817-2307
Phone (916) 734-6060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240712001360 CA Practitioner - Ophthalmology 4385017102 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Southern California Keck School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the Univ of CaGroup PAC ID 3375456619, 1,571 clinicians

Practice addresses (Care Compare)

14264 Innovation Dr
Folsom, CA 95630-4099
Phone (916) 985-9300

2261 Douglas Blvd
Roseville, CA 95661-3831
Phone (916) 783-7109

2315 Stockton Blvd
Sacramento, CA 95817-2201
Phone (916) 734-2011

2400 Del Paso Rd
Suite 145
Sacramento, CA 95834-9629
Phone (916) 928-3940

271 Turnpike Dr
Folsom, CA 95630-8098
Phone (916) 985-9200

4860 Y St
Sacramento, CA 95817-2307

4861 Y St
Sacramento, CA 95817-2307
Phone (916) 734-2525

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.15 of 100Reported as group
Quality
64.8
Promoting interoperability
100
Improvement activities
40
Cost
68.65

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery227

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A177534CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca Current Accepting new patients
Stanford Health Care Current Accepting new patients
Regents of the Univ of Ca CurrentSince Aug 21, 2024 Accepting new patients
Regents of the Univ of Ca Ophthalmology CurrentSince Aug 21, 2024 Accepting new patients
Regents of the University of California CurrentSince Sep 2, 2025 Accepting new patients
Regents of the University of California CurrentSince Sep 2, 2025 Accepting new patients
Regents of the Univ of Ca Past Accepting new patients

Locations

14264 Innovation Dr
Folsom, CA 95630
Phone (916) 946-9300

10850 White Rock Rd
Rancho Cordova, CA 95670

2400 Del Paso Rd
Ste 145
Sacramento, CA 95834
Phone (916) 928-3940

4860 Y St
Sacramento, CA 95817
Phone (916) 734-2700

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1585785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1558990515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4860 Y ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172307",
            "telephone_number": "916-734-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4860 Y ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172307",
            "telephone_number": "916-734-6060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "ANDREW",
        "middle_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-02",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A177534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.