NINA MARIE WATERCOTT (O.D.) – Optometrist, NPI 1922363415

NINA MARIE WATERCOTT (O.D.) is a healthcare provider. based in Otsego, Minnesota. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. 3320 (MN). The NPI Number for NINA MARIE WATERCOTT (O.D.) is 1922363415

Main info

Female
14 Years Of Experience
Accepts Medicare Assignment
Name
NINA MARIE WATERCOTT (O.D.)
NPI
1922363415
Phone
(763) 241-1090
Address
15704 90th St NE # 100
Enumeration Date
10 July 2012
Last Update Date
29 September 2020

Doctor Profile

Medical School Name
ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Secondary Phone
6125432500
Graduation Year
2012 (14 years ago)
PAC ID
8820245400
Group Practice PAC ID
7911892849
Professional Enrollment ID
I20130729000302
Address ID
MN554113047MI1313XAVEX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:13State licenses:1Digital endpointsOther names

879 OPTOMETRY in MN

Provider Addresses for NINA MARIE WATERCOTT (O.D.)

  • 15704 90th St NE # 100

    Otsego, MN 553307448

    Phone: (763) 241-1090

    Type: Location

  • 701 Park Ave

    Minneapolis, MN 554151623

    Phone: (612) 873-6963

    Type: Location

  • 4023 14TH AVE S APT 14A

    MINNEAPOLIS, MN 554073261

    Phone:

    Type: Mailing

  • 1313 PENN AVE N

    MINNEAPOLIS, MN 554113047

    Phone: (612) 543-2500

    Type: Location

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: 2013-07-29

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
I20130729000302IOptometryMNTBD

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 motion3730$0
99214Established patient office or other outpatient visit, 30-39 minutes2015$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: 7911892849View full group profile
NameSpecialtyState
Marriage And Family TherapistCA
-MN
Clinical Social WorkerMN
Clinical PsychologistMN
Mental Health CounselorMN
Nurse PractitionerMN
-MN
-MN
Clinical Social WorkerMN
Clinical Social WorkerMN

Reviews

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Frequently asked questions

What unique ID ties claims to NINA MARIE WATERCOTT (O.D.)?
NPI 1922363415 is assigned to NINA MARIE WATERCOTT (O.D.) under the national enumeration system.
Is NINA MARIE WATERCOTT (O.D.) currently active in the NPI registry?
CMS-published data lists NINA MARIE WATERCOTT (O.D.) as an active registrant.
What kind of provider is NINA MARIE WATERCOTT (O.D.)?
The page reflects Optometrist for NINA MARIE WATERCOTT (O.D.). Clinical services aligned with this taxonomy classification.
Does NINA MARIE WATERCOTT (O.D.) practice in Minnesota?
You will see Otsego, Minnesota on file for NINA MARIE WATERCOTT (O.D.) alongside any extra practice locations.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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