Individual provider Active NPI

Angela Elise Nicolini, O.D.

  • Optometrist
  • Abilene, TX
National Provider Identifier
1811005028
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
04853TG Issued in TX
Practice address
3225 S 27TH St
Abilene, TX 79605-6221
Phone
(325) 691-0101
Fax
(325) 691-8950
NPI assigned
Aug 28, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 04853TG TX Primary

Addresses

Primary practice location

3225 S 27TH St
Abilene, TX 79605-6221

Mailing address

3225 S 27TH St
Abilene, TX 79605-6221
Phone (325) 691-0101

Other identifiers 2

IdentifierTypeStateIssuer
A002OtherHUMANA/TRICARE
81010QOtherTXBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
04853TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Nicolini Enterprises, Inc. Optometrist Past Accepting new patients

Organizations & group practices 1

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": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811005028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3225 S 27TH ST",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796056221",
            "telephone_number": "325-691-0101",
            "fax_number": "325-691-8950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3225 S 27TH ST",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796056221",
            "telephone_number": "325-691-0101",
            "fax_number": "325-691-8950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOLINI",
        "first_name": "ANGELA",
        "middle_name": "ELISE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "04853TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA/TRICARE",
            "identifier": "A002",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "81010Q",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Abilene, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.