Individual provider Active NPI

Nicolas Antony Soulier, O.D.

  • Optometrist
  • Fort Wayne, IN
National Provider Identifier
1861468613
Registry record updated Mar 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18003244A Issued in IN
Practice address
5229 Coldwater Rd
Fort Wayne, IN 46825-5538
Phone
(260) 484-1453
Fax
(260) 483-8287
NPI assigned
Feb 23, 2006
Last updated
Mar 24, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18003244A IN Primary

Addresses

Primary practice location

5229 Coldwater Rd
Fort Wayne, IN 46825-5538

Mailing address

5229 Coldwater Rd
Fort Wayne, IN 46825-5538
Phone (260) 484-1453

Other practice location 1

6424 W Jefferson Blvd
Fort Wayne, IN 46804-6204
Phone (260) 969-1400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20050623000310 IN Practitioner - Optometry 0345285086 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nicolas a Soulier P CGroup PAC ID 0345547782, 5 clinicians

Practice addresses (Care Compare)

6424 W Jefferson Blvd
Fort Wayne, IN 46804-6204
Phone (260) 969-1400

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nicolas a Soulier P C Optometrist CurrentSince Feb 1, 2016 Accepting new patients
Nicolas a Soulier P C Optometrist CurrentSince Feb 1, 2016 Accepting new patients

Locations

5229 Coldwater Rd
Fort Wayne, IN 46825
Phone (260) 484-1453

6424 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 436-2020

Organizations & group practices 2

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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1861468613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5229 COLDWATER RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468255538",
            "telephone_number": "260-484-1453",
            "fax_number": "260-483-9259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5229 COLDWATER RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468255538",
            "telephone_number": "260-484-1453",
            "fax_number": "260-483-8287"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6424 W Jefferson Blvd",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468046204",
            "country_code": "US",
            "telephone_number": "260-969-1400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOULIER",
        "first_name": "NICOLAS",
        "middle_name": "ANTONY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003244A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.