DR. NICOLE RODDY MAISONVILLE OD
NPI 1215550439
Optometrist in Knoxville, TN

Q: What is Nicole Maisonville's NPI number?

The NPI number for Nicole Maisonville is 1215550439. It was assigned to this individual provider in the NPPES registry on May 21, 2020. The provider is also known as Dr. Nicole Leigh Roddy Od.

Q: What is Nicole Maisonville's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Active since May 21, 2020PECOS Enrolled

2100 CLINCH AVE STE 400, KNOXVILLE, TN 37916(865) 521-7998(865) 521-7405 Get Directions Write a Review

NPPES record last updated: March 9, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 9, 2022, Oct 21, 2020, Aug 19, 2020 and 2 more (5 updates tracked since 2020).

On this page

About Dr. Nicole Roddy Maisonville Od NPPES

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

DR. NICOLE RODDY MAISONVILLE OD (NPI 1215550439) is an individual optometrist in Knoxville, Tennessee, licensed in Tennessee (3610) and active in the NPI registry since May 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1215550439

Entity TypeIndividualFemale

Primary Taxonomy152W00000X

Provider Legal NameDR. NICOLE RODDY MAISONVILLECredential: OD

Location Address2100 CLINCH AVE STE 400Knoxville, TN 37916-2293

Mailing Address2100 Clinch Ave Ste 400Knoxville, TN 37916-2293 · (865) 521-7998 · Fax (865) 521-7405

Phone(865) 521-7998

Fax(865) 521-7405

Sole ProprietorNo

Enumeration DateMay 21, 2020

Last NPPES UpdateMarch 9, 20225 updates tracked since enumeration

NPPES CertifiedMarch 9, 2022

✔ NPI 1215550439 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers

Taxonomy Code152W00000X

License✔ Licensed in TN · 3610

Definition

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

2100 CLINCH AVE STE 400, Knoxville, TN 37916

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Other Names 1

Former Name (1)Dr. Nicole Leigh Roddy Od

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Louisiana, Blue Cross Blue Shield of Wyoming, BlueCross BlueShield of Tennessee and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Nicole Roddy Maisonville Od is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Nicole Maisonville reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Knoxville Pediatric Ophthalmology, PLLC

Same address

Ophthalmology

2100 W CLINCH AVE, SUITE 400 KOPPEL PLAZA
Knoxville, TN 37916

Reassigned Medicare billing, Tennessee enrollment
2 clinicians in this Medicare group

NPI 1174831887 (865) 521-7998

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37916 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

$121.80 typical visit price

range $52.64 – $160.89

Typical copayment $30.45 (range $13.16 – $40.22)

Most-billed visit code 99204

Established Patient

$66.01 typical visit price

range $16.72 – $131.41

Typical copayment $16.50 (range $4.18 – $32.85)

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.

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 Nicole Maisonville's NPI number?

The NPI number for Nicole Maisonville is 1215550439. It was assigned to this individual provider in the NPPES registry on May 21, 2020. The provider is also known as Dr. Nicole Leigh Roddy Od.

Where is Nicole Maisonville located?

Nicole Maisonville practices at 2100 Clinch Ave Ste 400, Knoxville, TN 37916. The listed phone number is (865) 521-7998.

What is Nicole Maisonville's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Nicole Maisonville enrolled in Medicare?

Yes. Nicole Maisonville is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Nicole Maisonville's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nicole Maisonville reassigns Medicare benefits to Knoxville Pediatric Ophthalmology, PLLC (Knoxville, TN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Nicole Maisonville's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Nicole Maisonville accept?

Health plans from Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana, BlueCross BlueShield of Tennessee, Cigna Healthcare and UnitedHealthcare list Nicole Maisonville 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.

When was this NPI record last updated?

The NPPES record for Nicole Maisonville was last updated on March 9, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.