DR. SUSAN J ANDERSON-NELSON M.D.
NPI 1013904986
Ophthalmology - Retina Specialist in Wheaton, IL

Active since October 05, 2005PECOS EnrolledAccepts Medicare Assignment
94.1/100
CMS Quality Rating
2015 N MAIN ST, WHEATON, IL 60187(630) 668-8250(630) 668-8916 Get Directions Write a Review

NPPES record last updated: August 21, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 21, 2024, Oct 5, 2022, Apr 21, 2021 (3 updates tracked since 2021).

About Dr. Susan J Anderson-nelson M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SUSAN J ANDERSON-NELSON M.D. (NPI 1013904986) is an individual retina specialist in Wheaton, Illinois, licensed in Illinois (036079057) and active in the NPI registry since October 2005. She is enrolled in Medicare PECOS, is affiliated with John H Stroger Jr Hospital, and is a graduate of Rush Medical College Of Rush University (1986).

NPPES Registry Identity

NPI1013904986
Entity TypeIndividualFemale
Primary Taxonomy207WX0107X
Provider Legal NameDR. SUSAN J ANDERSON-NELSONCredential: M.D.
Location Address2015 N MAIN STWheaton, IL 60187-3152
Mailing Address2015 N Main StWheaton, IL 60187-3152 · (630) 668-8250 · Fax (630) 668-8916
Fax(630) 668-8916
Sole ProprietorNo
Medical School CMSRush Medical College Of Rush UniversityGraduated 1986
Enumeration DateOctober 5, 2005
Last NPPES UpdateAugust 21, 20243 updates tracked since enumeration
NPPES CertifiedAugust 21, 2024
NPI 1013904986 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyOphthalmology · Retina SpecialistAllopathic & Osteopathic Physicians
Taxonomy Code207WX0107X
License Licensed in IL · 036079057
Definition
An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases.
Also ListedOphthalmologyTaxonomy 207W00000X · License 36-079057 (IL)
2015 N MAIN ST, Wheaton, IL 60187

Other Identifiers 2

Other180012234IL · Rr Medicare
Medicaid036079057IL

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Susan J Anderson-nelson M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2365425451
PECOS Enrollment IDI20100206000149
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 17

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Injection, faricimab-svoa, 0.1 mg J2777
Faricimab-svoa is a medication given through an injection into the eye to treat certain eye conditions. The 0.1 mg dosage helps control disease progression, improving vision and eye health. The procedure is done by a healthcare professional.
34,920 services140 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
2,472 services1,064 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
1,315 services968 patients
Injection of drug into eye 67028
An injection into the eye is a procedure where a medication is delivered directly into your eye to treat various conditions. A local anesthetic is applied to numb the eye, ensuring minimal discomfort. The drug helps manage diseases like macular degeneration or diabetic retinopathy.
1,239 services326 patients
Injection, aflibercept, 1 mg J0178
Aflibercept injection is a treatment for certain eye conditions that affect vision. It works by blocking abnormal blood vessel growth and leakage in the eye, which can cause vision loss. The medication is administered directly into the eye by a healthcare professional.
710 services116 patients
Injection, ranibizumab, 0.1 mg J2778
Ranibizumab is a medication given via injection to treat certain eye conditions like age-related macular degeneration. It works by slowing vision loss and in some cases, improving vision by blocking abnormal blood vessel growth in the eye.
320 services12 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

John H Stroger Jr Hospital

Acute Care Hospitals · Chicago, IL
2/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number140124
Location1901 W Harrison StChicago, IL 60612 · Cook County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60187 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$137.43 typical visit price
range $59.81 – $181.38
Typical copayment $34.35 (range $14.95 – $45.34)
Most-billed visit code 99204
Established Patient
$74.38 typical visit price
range $19.15 – $147.12
Typical copayment $18.59 (range $4.78 – $36.78)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

94.1/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality82.59
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
100%98 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Optometrist
2015 N MAIN ST
WHEATON, IL 60187
Ophthalmology (Glaucoma Specialist)
2015 N MAIN ST
WHEATON, IL 60187
Ophthalmology
2015 N MAIN ST
WHEATON, IL 60187
Ophthalmology (Glaucoma Specialist)
2015 N MAIN ST
WHEATON, IL 60187
Ophthalmology
2015 N MAIN ST
WHEATON, IL 60187
Ophthalmology (Pediatric Ophthalmology and Strabismus Specialist)
2015 N MAIN ST
WHEATON, IL 60187
Ophthalmology
2015 N MAIN ST
WHEATON, IL 60187
Optometrist
2015 N MAIN ST
WHEATON, IL 60187

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Susan Anderson-nelson's NPI number?

The NPI number for Susan Anderson-nelson is 1013904986. It was assigned to this individual provider in the NPPES registry on October 5, 2005.

Where is Susan Anderson-nelson located?

Susan Anderson-nelson practices at 2015 N Main St, Wheaton, IL 60187. The listed phone number is (630) 668-8250.

What is Susan Anderson-nelson's specialty?

The primary specialty registered for this NPI is Ophthalmology, specializing in Retina Specialist, with taxonomy code 207WX0107X.

Is Susan Anderson-nelson enrolled in Medicare?

Yes. Susan Anderson-nelson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Susan Anderson-nelson accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Home State Health list Susan Anderson-nelson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Susan Anderson-nelson affiliated with any hospitals?

According to CMS data, Susan Anderson-nelson is affiliated with John H Stroger Jr Hospital.

When was this NPI record last updated?

The NPPES record for Susan Anderson-nelson was last updated on August 21, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.