KAYLYN MARIE NICKELSON (OD) – Optometrist, NPI 1467930735

KAYLYN MARIE NICKELSON (OD) is a healthcare provider. based in Springfield, Illinois. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 046011215 (IL). The NPI Number for KAYLYN MARIE NICKELSON (OD) is 1467930735

Main info

Female
8 Years Of Experience
Accepts Medicare Assignment
Name
KAYLYN MARIE NICKELSON (OD)
NPI
1467930735
Phone
(217) 698-3030
Address
2020 W ILES AVE
Enumeration Date
30 July 2018
Last Update Date
18 March 2025

Doctor Profile

Medical School Name
INDIANA UNIVERSITY - SCHOOL OF OPTOMETRY
Secondary Phone
2176983030
Graduation Year
2018 (8 years ago)
PAC ID
3779833587
Group Practice PAC ID
6507779824
Professional Enrollment ID
I20180829000000
Address ID
IL627044174SP2020XAVEX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness75
Years active:7State licenses:1Digital endpointsOther names

1,715 OPTOMETRY in IL

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Provider Addresses for KAYLYN MARIE NICKELSON (OD)

  • 2020, West Iles Avenue, Springfield, Sangamon County, Illinois, 62704, United States

    SPRINGFIELD, IL 627047015

    Phone: (217) 698-3030

    Fax: (217) 698-4728

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 26 Open Payments records for all available years, with a total value of $661.

Total Amount is formed as General ($661) + Research ($0) + Ownership ($0) = $661.

Last reported payment date: 2024-11-25 • Largest payer in this snapshot: Alcon Vision LLC ($265).

Total Amount

$661

General + Research + Ownership

Payments

26

Total payment records

General Amount

$661

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-25

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-08-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180829000000IOptometryILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
92014Established patient complete exam of visual system222199$0
92083Exam of visual field with extended testing9363$0
92012Established patient problem focused exam of visual system6754$0
92133Imaging of optic nerve6662$0
92134Imaging of retina3934$0
View full utilization report →

Insurance plans in this area (ZIP 62704)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6507779824View full group profile
NameSpecialtyState
O P T O M E T R YIL
O P T O M E T R YIL
O P T O M E T R YIL
O P T O M E T R YIL
O P H T H A L M O L O G YMD
O P T O M E T R YIL
O P T O M E T R YIL
O P H T H A L M O L O G YIL
O P H T H A L M O L O G YIL
O P H T H A L M O L O G YNC

Reviews

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Frequently asked questions

What NPI should I save for KAYLYN MARIE NICKELSON (OD)?
Save NPI 1467930735 if you need a stable reference for KAYLYN MARIE NICKELSON (OD).
Does this profile mean KAYLYN MARIE NICKELSON (OD) is currently active?
Yes — KAYLYN MARIE NICKELSON (OD) appears active in the national provider directory.
What kind of provider is KAYLYN MARIE NICKELSON (OD)?
The page reflects Optometrist for KAYLYN MARIE NICKELSON (OD). Clinical services aligned with this taxonomy classification.
Where does public data place KAYLYN MARIE NICKELSON (OD)?
The snapshot lists Springfield, Illinois for KAYLYN MARIE NICKELSON (OD); download NPPES for the complete set.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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