Nathaniel Richard Nielsen, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT-002514 Issued in AZ

Practice address

7080 W Sanna St
Peoria, AZ 85345-8898

Phone

(208) 406-6573

NPI assigned

May 26, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mountainview Vision Center PCGroup PAC ID 0345620449, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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.

• Mountainview Vision Center PC

  • Optometrist
  • Kingman, AZ
  • NPI 1225774524
  Medicare reassignment Care Compare group NPD
• Jason C Allen DPM PLLC

  • Foot & Ankle Surgery Podiatrist
  • Kingman, AZ
  • NPI 1164459343
  NPD

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

{
    "created_epoch": "1621987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628121600000",
    "number": "1972178523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7080 W SANNA ST",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853458898",
            "telephone_number": "208-406-6573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7080 W SANNA ST",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853458898",
            "telephone_number": "208-406-6573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "NATHANIEL",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-26",
        "last_updated": "2021-08-05",
        "certification_date": "2021-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "OPT-002514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nice Nice Dental
• Kathleen Bronson Nicholas, FNP-C
• Megan Nicholas, PA
• Nico Health LLC
• Noah Nicolai, DC
• Mikhail Andrew Nikiforov, DPT
• Caitlin Elizabeth Nilsen, LPN
• Ann Zoebisch Nimlos, R.PH.
• Victor L. Nitu, DDS
• Michael B Nix, MD, DMD

• Optometrist in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2021; 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.