EMILY NELSEN (OD) – Optometrist, NPI 1386310787

EMILY NELSEN (OD) is a healthcare provider. based in Otsego, Minnesota. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. OD61166966 (WA). The NPI Number for EMILY NELSEN (OD) is 1386310787

Main info

Female
5 Years Of Experience
Accepts Medicare Assignment
Name
EMILY NELSEN (OD)
NPI
1386310787
Phone
(763) 241-1090
Address
15704 90TH ST NE # 100
Enumeration Date
17 August 2021
Last Update Date
4 January 2023

Doctor Profile

Medical School Name
UNIVERSITY OF MISSOURI ST LOUIS - SCHOOL OF OPTOMETRY
Secondary Phone
7632411090
Graduation Year
2021 (5 years ago)
PAC ID
2860863727
Group Practice PAC ID
1456360403
Professional Enrollment ID
I20230201000596
Address ID
MN553307448OT15704NEXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:4State licenses:1Digital endpointsOther names

881 OPTOMETRY in MN

Provider Addresses for EMILY NELSEN (OD)

  • 15704 90TH ST NE # 100

    OTSEGO, MN 553307448

    Phone: (763) 241-1090

    Fax: (763) 241-1091

    Type: Mailing

  • 13889 RIDGEDALE DR

    MINNETONKA, MN 553051768

    Phone: (763) 241-1090

    Fax: (763) 241-1091

    Type: Location

  • 15704 90th St NE # 100

    Otsego, MN 553307448

    Phone: (763) 241-1090

    Fax: (763) 241-1091

    Type: Location

  • 1705 S 324TH PL

    FEDERAL WAY, WA 980038504

    Phone: (253) 661-6005

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2023-02-01

PECOS data refreshed: 2026-06-15

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
I20230201000596IOptometryMNTBD

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
92060Exam to measure eye deviation and range of motion9259$0
99214Established patient office or other outpatient visit, 30-39 minutes9270$0
92083Exam of visual field with extended testing3935$0
99204New patient office or other outpatient visit, 45-59 minutes3131$0
View full utilization report →

Insurance plans in this area (ZIP 55330)

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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: 1456360403View full group profile
NameSpecialtyState
-MN
O P T O M E T R YMN

Reviews

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Frequently asked questions

Is EMILY NELSEN (OD) listed with a National Provider Identifier?
Yes — EMILY NELSEN (OD) has NPI 1386310787 on file in the registry.
Would EMILY NELSEN (OD) appear as active to a payer?
You can treat EMILY NELSEN (OD) as active for directory purposes; confirm clinical privileges separately.
What expertise is attributed to EMILY NELSEN (OD)?
EMILY NELSEN (OD)'s specialty line reads Optometrist. Clinical services aligned with this taxonomy classification.
Where in Minnesota is EMILY NELSEN (OD) registered?
Use Otsego, Minnesota as the headline location for EMILY NELSEN (OD) here.
What does 5 location(s) imply?
5 practice locations appear in the available data.

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