Individual provider Active NPI

Nasim Nikoumanesh, O.D.

  • Optometrist
  • Chicago, IL
National Provider Identifier
1982852208
Registry record updated Jan 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046010124 Issued in IL
Practice address
1200 N Larrabee St
Target Optical
Chicago, IL 60610
Phone
(312) 475-0896
Fax
(312) 477-2151
NPI assigned
Aug 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046010124 IL Primary

Addresses

Primary practice location

1200 N Larrabee St
Target Optical
Chicago, IL 60610

Mailing address

1440 W Taylor St Ste 4152
Chicago, IL 60607-4623
Phone (312) 475-0896

Other names 1

  • Dr. Nasim Nikoumanesh Former name

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
I20080924000498 IL Practitioner - Optometry 0042387573 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1200 N Larrabee St
Chicago, IL 60610-1746
Phone (312) 475-0896

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nikoumanesh Eye Care LLC Optometrist CurrentSince Apr 1, 2023 Accepting new patients

Locations

1200 N Larrabee St
Chicago, IL 60610
Phone (312) 470-8945

1440 W Taylor St
Chicago, IL 60607
Phone (612) 263-9334

Interoperability endpoints

  • Direct secure messaging: nasimnikoumanesh@direct.revolutionehr.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1219881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768089600000",
    "number": "1982852208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 W TAYLOR ST STE 4152",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606074623",
            "telephone_number": "312-475-0896",
            "fax_number": "312-477-2151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N LARRABEE ST",
            "address_2": "TARGET OPTICAL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60610",
            "telephone_number": "312-475-0896",
            "fax_number": "312-477-2151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIKOUMANESH",
        "first_name": "NASIM",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-28",
        "last_updated": "2026-01-11",
        "certification_date": "2026-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NASIM",
            "last_name": "NIKOUMANESH",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.