Individual provider Active NPI

Nicole Marie Collins, O.D.

  • Optometrist
  • Fargo, ND
National Provider Identifier
1639425556
Registry record updated Jul 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
701 Issued in ND
Practice address
2601 University Dr S
Fargo, ND 58103-6025
Phone
(701) 235-5200
NPI assigned
Jul 29, 2012
Last updated
Jul 29, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 701 ND Primary

Addresses

Primary practice location

2601 University Dr S
Fargo, ND 58103-6025

Mailing address

5212 Bishops Blvd S Unit C
Fargo, ND 58104-7278
Phone (215) 317-5472

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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
I20120905000126 ND Practitioner - Optometry 0648427237 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Consultants of Fargo PLLCGroup PAC ID 5890045785, 10 clinicians

Practice addresses (Care Compare)

3171 44TH St S
Unit 101
Fargo, ND 58104-8521
Phone (701) 235-0561

Merit-based Incentive Payment System (MIPS)

Final score
61.92 of 100Reported as group
Quality
72.3
Improvement activities
40
Cost
10

Merit-based Incentive Payment System (MIPS)

Final score
80.83 of 100Reported as group
Quality
72.3
Improvement activities
40
Cost
73.03

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Consultants of Fargo, PLLC Optometrist CurrentSince Aug 1, 2023 Accepting new patients
Premier Optical, LLC Optometrist Current Accepting new patients
Steven B Thom, MD PC CurrentSince Dec 28, 2020 Accepting new patients

Locations

2601 University Dr S
Fargo, ND 58103
Phone (701) 235-5200

3171 44th St S
Unit 101
Fargo, ND 58104
Phone (800) 437-4387

Organizations & group practices 3

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": "1343520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343520000000",
    "number": "1639425556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5212 BISHOPS BLVD S UNIT C",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047278",
            "telephone_number": "215-317-5472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 UNIVERSITY DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036025",
            "telephone_number": "701-235-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-29",
        "last_updated": "2012-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ND",
            "license": "701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.