Stanton Nielsen Jr., D.O.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

036.163773 Issued in IL

Practice address

2650 Ridge Ave Ste 1304
Evanston, IL 60201-1700

Phone

(480) 338-1585

NPI assigned

Apr 28, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

General Surgery

Education

Arizona College of Osteopathic Medicine Mid Western University, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kingman Healthcare IncGroup PAC ID 6901791367, 185 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kingman Regional Medical Center Hospital, Kingman, AZ, CCN 030055

Merit-based Incentive Payment System (MIPS)

Final score

84.85 of 100Reported as group

Quality

84.49

Promoting interoperability

83

Improvement activities

40

Cost

79.17

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nielsen.stanton@direct.azkrmc.md

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kingman Healthcare, Inc

  • General Acute Care Hospital
  • Kingman, AZ
  • NPI 1265423917

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Kingman Healthcare, Inc

  • Specialist
  • Kingman, AZ
  • NPI 1689897787

  Family Medicine

  NPD
• Kingman Healthcare, Inc

  • Community/Retail Pharmacy
  • Kingman, AZ
  • NPI 1992286298
  NPD

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

• Kingman Healthcare, Inc

  • General Acute Care Hospital
  • Kingman, AZ
  • NPI 1265423917
  Care Compare affiliation

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

{
    "created_epoch": "1493337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1700311560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 HARVESTER DR STE 110",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605276686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE STE 1304",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011700",
            "telephone_number": "480-338-1585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "STANTON",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-28",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036.163773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vinh Quang Nguyen
• Ziling Ni
• Nicholas Dunkas MD and Associates
• James Earl Nicholas, M.A.
• Jacqueline Wynne Nichols, MD
• Tracy Nieman, LCPC
• Erica Lea Nigh
• Velizar T Nikiforov
• John Nick Nikitas, MD
• Mariam Nikolaishvili, MD

• Surgery Physician in Evanston, IL
• Providers in Evanston, IL by specialty
• Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; 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.