Edward R Nicholls, OD in American Fork, UT - Medicare Optometrist Provider

Edward R Nicholls, OD is a medicare enrolled "Optometrist" provider in American Fork, Utah. His current practice location is 323 W State Rd Ste A, American Fork, Utah. You can reach out to his office (for appointments etc.) via phone at (801) 763-9898.

Edward R Nicholls is licensed to practice in Utah (license number 8746430-9934) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1376981175.

Contact Information

	Edward R Nicholls, OD
	323 W State Rd Ste A, American Fork, UT 84003-5600
	(801) 763-9898
	(801) 763-7217

Map and Direction

Healthcare Provider's Profile

Full Name	Edward R Nicholls
Gender	Male
Speciality	Optometrist
Location	323 W State Rd Ste A, American Fork, Utah
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1376981175
Provider Enumeration Date: 06/13/2013
Last Update Date: 10/20/2022

Medicare PECOS Information:

PECOS PAC ID: 6901035351
Enrollment ID: I20140204001847

Medical Identifiers

Medical identifiers for Edward R Nicholls such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1376981175	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
152W00000X	Optometrist	8746430-9934 (Utah)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Edward R Nicholls allows following entities to bill medicare on his behalf.

Provider Name	University Of Utah Adult Services
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1114321981 PECOS PAC ID: 0941525273 Enrollment ID: O20150209001683

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Edward R Nicholls is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Edward R Nicholls, OD 323 W State Rd Ste A, American Fork, UT 84003-5600 Ph: (801) 763-9898	Edward R Nicholls, OD 323 W State Rd Ste A, American Fork, UT 84003-5600 Ph: (801) 763-9898

Reviews and Comments

Optometrist in American Fork, UT

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Edward R Nicholls, OD - Medicare Optometrist in American Fork, UT