David Paul Nelson, O.D.

Individual provider Active NPI Optometrist · Cottage Grove, WI

NPI 1992878409 · NPPES record last updated Jul 22, 2016

Key facts

NPI
1992878409
Entity type
Individual (NPI type 1)
Primary specialty
Optometrist 152W00000X
License
2723 (WI)
Practice address
427 W Cottage Grove Rd
Cottage Grove, WI 53527-9385
Phone
(608) 839-0980
Fax
(608) 839-0982
NPI assigned
Nov 15, 2006
Sex
Male
Sole proprietor
Yes

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.

Medicare Care Compare profile

Specialty
Optometry
Education
Ohio State University - College of Optometry, 1998
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

427 W Cottage Grove Rd
Cottage Grove, WI 53527-9385
Phone (608) 839-0980

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20110304000148 WI Practitioner - Optometry 3870775372 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
2723WIMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
DP Nelson Investments LLC Optometrist Current
since May 13, 2014
Accepting new patients

Locations

427 W Cottage Grove Rd
Cottage Grove, WI 53527
Phone (608) 332-9818

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2723 WI Yes

Addresses

Primary practice location

427 W Cottage Grove Rd
Cottage Grove, WI 53527-9385

Mailing address

427 W Cottage Grove Rd
Cottage Grove, WI 53527-9385
Phone (608) 839-0980

Other providers in Cottage Grove, WI

All providers in Cottage Grove, WI · Optometrist in Wisconsin

Sources for this page

Verify at the official NPI Registry.