DR. ERIC RICHARD NELSON M.D.
NPI 1619946811
Ophthalmology - Ophthalmic Plastic and Reconstructive Surgery in Edina, MN
NPI Status: Active since March 17, 2006
Contact Information
6405 FRANCE AVE S
SUITE W460
EDINA, MN
ZIP 55435
Phone: (952) 925-4162
Fax: (952) 925-3520
- Individual
- Male
- Years of Experience 42
- Ophthalmology
- Ophthalmic Plastic and Reconstructive Su...
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About ERIC NELSON
This page provides the complete NPI Profile along with additional information for Eric Nelson, a provider established in Edina, Minnesota with a medical specialization in Ophthalmology, focusing in ophthalmic plastic and reconstructive surgery and more than 42 years of experience. He graduated from University Of Iowa, Rj & L Carver College Of Medicine in 1985. The healthcare provider is registered in the NPI registry with number 1619946811 assigned on March 2006. The practitioner's primary taxonomy code is 207WX0200X with license number 33370 (MN). The provider is registered as an individual and his NPI record was last updated 9 years ago.
- NPI
- 1619946811
- Provider Name
- DR. ERIC RICHARD NELSON M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 6405 FRANCE AVE S SUITE W460 EDINA, MN 55435
- Location Phone
- (952) 925-4162
- Location Fax
- (952) 925-3520
- Mailing Address
- 6405 FRANCE AVE S SUITE W460 EDINA, MN 55435
- Mailing Phone
- (952) 925-4162
- Mailing Fax
- (952) 925-3520
- Medical School Name
- UNIVERSITY OF IOWA, RJ & L CARVER COLLEGE OF MEDICINE
- Graduation Year
- 1985
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 03-17-2006
- Last Update Date
- 03-23-2017
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Ophthalmology Ophthalmic Plastic and Reconstructive Surgery
- Taxonomy Code
- 207WX0200X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 33370
- License State
- MN
- Taxonomy Description
- A physician who specializes in oculofacial plastic and reconstructive surgery. This subspecialty combines orbital and periocular surgery with facial plastic surgery, and includes aesthetic and reconstructive surgery of the face, orbit, eyelid, and lacrimal system. Practitioners evaluate, diagnose and treat conditions involving the eyelids, brows, midface, orbits, lacrimal systems and surrounding and supporting structures of the face and neck.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Atlas $1,300 Gold - PPO
- Atlas $2,000 Standard Gold - PPO
- Atlas $3,050 Plus Silver - PPO
- Atlas $3,800 HSA Silver - PPO
- Atlas $6,000 Standard Silver - PPO
- Atlas $6,800 Plus Bronze HSA - PPO
- Atlas $7,500 Standard Bronze HSA - PPO
- Atlas $8,400 HSA Bronze - PPO
- Medica Individual Choice Bronze $0 Copay PCP Visits - HMO
- Medica Individual Choice Bronze HSA - EPO
- Medica Individual Choice Bronze Share - EPO
- Medica Individual Choice Bronze Share - HMO
- Medica Individual Choice Expanded Bronze Standard - EPO
- Medica Individual Choice Expanded Bronze Standard - HMO
- Medica Individual Choice Gold $0 Copay PCP Visits - EPO
- Medica Individual Choice Gold $0 Copay PCP Visits - HMO
- Medica Individual Choice Gold Share - EPO
- Medica Individual Choice Gold Share - HMO
- Medica Individual Choice Gold Standard - EPO
- Medica Individual Choice Gold Standard - HMO
- Medica Individual Choice Silver $0 Copay PCP Visits - EPO
- Medica Individual Choice Silver $0 Copay PCP Visits - HMO
- Medica Individual Choice Silver Share - EPO
- Medica Individual Choice Silver Share - HMO
- Medica Individual Choice Silver Standard - EPO
- Medica Individual Choice Silver Standard - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 323003100 | MEDICAID (05) | MN | |
| 180000287 | MEDICARE PIN (08) | MN |
Medicare Participation & PECOS Enrollment Status
Eric Nelson is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Eric Nelson is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 5092803056
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20071109000028
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Established patient office or other outpatient visit, 10-19 minutes
Exam of visual field with limited testing
Injection, onabotulinumtoxina, 1 unit
Melanoma (skin cancer) excision
New patient office or other outpatient visit, 15-29 minutes
New patient office or other outpatient visit, 30-44 minutes
Photography of content of eyes
Removal of excessive skin and fat of upper eyelid
Repair of brow paralysis
Repair of tendon of upper eyelid
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
This service was performed 28 times for 27 patientsAn exam of the visual field with limited testing is a quick check of your peripheral vision. It involves identifying objects or movements at the edge of your sight, helping to detect any vision loss that isn't obvious, such as blind spots or areas of reduced vision.
This service was performed 67 times for 67 patientsOnabotulinumtoxina, also known as Botox, is a medication injected into muscles. It's used to treat various conditions by blocking nerve activity in the muscles, causing a temporary reduction in muscle activity. The units refer to the dosage.
This service was performed 3,000 times for 11 patientsMelanoma excision is a procedure where a surgeon removes melanoma, a type of skin cancer, and some surrounding healthy tissue. Local anesthesia is applied to numb the area. The goal is to completely remove the cancer and prevent its spread. Healing time varies.
This service was performed for 1-10 patientsThis service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.
This service was performed 33 times for 33 patientsThis service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
This service was performed 81 times for 81 patientsPhotography of the content of eyes, also known as ocular photography, captures detailed images of different parts of the eye. It helps identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. The process is non-invasive and painless.
This service was performed 110 times for 110 patientsThis procedure, also known as upper eyelid surgery, is performed to remove excess skin and fat from the upper eyelid. It can help improve vision if heavy eyelids hinder it, and can also enhance the appearance of the eyes. It's a common, safe procedure.
This service was performed 27 times for 27 patientsRepair of brow paralysis is a procedure aimed to restore function and symmetry to the face. This is achieved by adjusting muscles and nerves in the brow area. It can help improve the appearance and movement of the forehead and eyebrows, enhancing overall facial expressions.
This service was performed 23 times for 23 patientsRepair of the tendon of the upper eyelid is a surgical procedure aimed at fixing a droopy eyelid. This condition can affect your vision and appearance. The procedure involves tightening the tendon to lift the eyelid to its normal position, improving both function and aesthetics.
This service was performed 35 times for 32 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $31.9 for a new patient copayment and $17.43 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 55435 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $127.61
- Minimum New Patient Price $56
- Maximum New Patient Price $168.28
- Average New Patient Copayment $31.9
- Minimum New Patient Copayment $14
- Maximum New Patient Copayment $42.07
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $69.74
- Minimum Established Patient Price $18.32
- Maximum Established Patient Price $138.04
- Average Established Patient Copayment $17.43
- Minimum Established Patient Copayment $4.58
- Maximum Established Patient Copayment $34.51
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Eric Nelson is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| ABBOTT NORTHWESTERN HOSPITAL | 800 EAST 28TH STREET MINNEAPOLIS, MN 55407 | (612) 863-4000 | Acute Care Hospitals |
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1619946811, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 69. The final step is to find the difference between that total and the next multiple of ten (70 - 69 = 1).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 69 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
EDINA, MN 55435
EDINA, MN 55435
EDINA, MN 55435
EDINA, MN 55435
EDINA, MN 55435
EDINA, MN 55435
EDINA, MN 55435
EDINA, MN 55435
EDINA, MN 55435
EDINA, MN 55435
EDINA, MN 55435
EDINA, MN 55435
EDINA, MN 55435
EDINA, MN 55435
EDINA, MN 55435
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1619946811, enumerated as an "individual" on March 17, 2006.
The provider is located at 6405 FRANCE AVE S SUITE W460 EDINA, MN 55435 and the phone number is (952) 925-4162.
Ophthalmology with taxonomy code 207WX0200X and a focus in Ophthalmic Plastic and Reconstructive Surgery.
The provider might be accepting Accepts: HealthPartners, Medica, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
Eric Nelson is affiliated with: ABBOTT NORTHWESTERN HOSPITAL.