Individual provider Active NPI

Nicholas James Blasco, O.D.

  • Optometrist
  • Des Moines, IA
National Provider Identifier
1801238100
Registry record updated Aug 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046011522 Issued in IL
Practice address
2566 Hubbell Ave
Des Moines, IA 50317-6102
Phone
(515) 262-1094
NPI assigned
Jul 27, 2013
Last updated
Aug 2, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA2370 MD
Optometrist 152W00000X 046011522 IL Primary
Optometrist 152W00000X 002583 IA

Addresses

Primary practice location

2566 Hubbell Ave
Des Moines, IA 50317-6102

Mailing address

400 W Dundee Rd
Ste 14-15
Buffalo Grove, IL 60089-3415
Phone (515) 306-7213

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220204001944 IL Practitioner - Optometry 8022241819 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chicago Cornea Consultants LTDGroup PAC ID 6608771324, 10 clinicians

Practice addresses (Care Compare)

1585 N Barrington Rd
Suite 502
Hoffman Estates, IL 60169-5020
Phone (847) 255-3515

806 Central Ave
Suite 300
Highland Park, IL 60035-5613
Phone (847) 255-3515

Merit-based Incentive Payment System (MIPS)

Final score
89.96 of 100Reported as group
Quality
91.74
Improvement activities
40
Cost
77.56

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TA2370MDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Alan Optical PLLC Optometrist CurrentSince Jan 21, 2022 Accepting new patients
United Eye Care Providers, LLC Optometrist Past Accepting new patients
Eye Care of Iowa P.C. Optometrist Past Accepting new patients

Locations

400 W Dundee Rd
Buffalo Grove, IL 60089
Phone (847) 459-9119

400 W Dundee Rd
Ste 14
Buffalo Grove, IL 60089

400 W Dundee Rd
Ste 1415
Buffalo Grove, IL 60089
Phone (847) 459-9119

Interoperability endpoints

  • Direct secure messaging: nblasco@cccltd.intellechartdirect.net

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": "1374883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1801238100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W DUNDEE RD",
            "address_2": "STE 14-15",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600893415",
            "telephone_number": "515-306-7213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2566 HUBBELL AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503176102",
            "telephone_number": "515-262-1094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLASCO",
        "first_name": "NICHOLAS",
        "middle_name": "JAMES",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-27",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA2370",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046011522",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "002583",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.