Individual provider Active NPI

Nelson Howard Hassell, O.D.

  • Optometrist
  • Kingsford, MI
National Provider Identifier
1689771487
Registry record updated Dec 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901003162 Issued in MI
Practice address
401 Woodward Ave
Kingsford, MI 49802-4630
Phone
(906) 774-0611
Fax
(906) 774-2796
NPI assigned
Sep 20, 2006
Last updated
Dec 16, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901003162 MI Primary
Optometrist 152W00000X 2242-035 WI

Addresses

Primary practice location

401 Woodward Ave
Kingsford, MI 49802-4630

Mailing address

401 Woodward Ave
Kingsford, MI 49802-4630
Phone (906) 774-0611

Other identifiers 2

IdentifierTypeStateIssuer
900B26512OtherMIBC/BS #
38578900MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20080215000566 MI Practitioner - Optometry 7719060532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

401 Woodward Ave
1 Vision Source Kingsford
Kingsford, MI 49802-4600
Phone (906) 774-0611

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2242-035WIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
1 Vision S.C. Optometrist PastSince Jun 15, 2015 Accepting new patients
Spectacular Visions LTD Optometrist Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: drhassell@visionsource-kingsford.direct.eyemdemr.com

Organizations & group practices 4

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229385600000",
    "number": "1689771487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 WOODWARD AVE",
            "city": "KINGSFORD",
            "state": "MI",
            "postal_code": "498024630",
            "telephone_number": "906-774-0611",
            "fax_number": "906-774-2796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 WOODWARD AVE",
            "city": "KINGSFORD",
            "state": "MI",
            "postal_code": "498024630",
            "telephone_number": "906-774-0611",
            "fax_number": "906-774-2796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASSELL",
        "first_name": "NELSON",
        "middle_name": "HOWARD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2008-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003162",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2242-035",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS #",
            "identifier": "900B26512",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38578900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsford, MI

Sources for this page

Verify at the official NPI Registry.