Charlotte Florence Nielsen, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046008590 Issued in IL

Practice address

1120 E Washington St
Grayslake, IL 60030-7960

Phone

(847) 223-2000

Fax

(847) 223-9400

NPI assigned

Oct 21, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dr Charlotte F Nielsen PCGroup PAC ID 0143345447, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Dr. Charlotte F. Nielsen, P.C.

  • Optometrist
  • Grayslake, IL
  • NPI 1033303169
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213315200000",
    "number": "1962492975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 E WASHINGTON ST",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600307960",
            "telephone_number": "847-223-2000",
            "fax_number": "847-223-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 E WASHINGTON ST",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600307960",
            "telephone_number": "847-223-2000",
            "fax_number": "847-223-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "CHARLOTTE",
        "middle_name": "FLORENCE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-21",
        "last_updated": "2008-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046008590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046008590",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORPORATE NPI",
            "identifier": "1033303169",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Jai Jung Nho, M.D.
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• North Suburban Counseling, PC
• Northern Rose Caregivers
• Northwestern Medical Faculty Foundation
• Jill Novacek, MSW, LCSW, LSOTP

• Optometrist in Grayslake, IL
• Providers in Grayslake, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2008; 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.