DR. ALISA KOURTNEY NICHOLSON OD
NPI 1790186211
Optometrist in Douglasville, GA
About Dr. Alisa Kourtney Nicholson Od NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. ALISA KOURTNEY NICHOLSON OD (NPI 1790186211) is an individual optometrist in Douglasville, Georgia, licensed in Georgia (OPT002881) and active in the NPI registry since September 2014. She is enrolled in Medicare PECOS and is a graduate of Illinois College Of Optometry At Chicago (2014).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Alisa Kourtney Nicholson Od 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.
Medicare Billing Reassignment
Medicare enrollment records show Alisa Nicholson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Douglasville, GA 30135
- Reassigned Medicare billing, Georgia enrollment
- 11 clinicians in this Medicare group
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 30135 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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 Alisa Nicholson's NPI number?
The NPI number for Alisa Nicholson is 1790186211. It was assigned to this individual provider in the NPPES registry on September 16, 2014.
Where is Alisa Nicholson located?
Alisa Nicholson practices at 6700 Douglas Blvd Ste 1270, Douglasville, GA 30135. The listed phone number is (770) 942-9827.
What is Alisa Nicholson's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Alisa Nicholson enrolled in Medicare?
Yes. Alisa Nicholson 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.
Which organization bills Medicare for Alisa Nicholson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Alisa Nicholson reassigns Medicare benefits to Infocus Eye Care, Inc. (Douglasville, GA). 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 Alisa Nicholson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Alisa Nicholson accept?
Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee and 5 other insurers list Alisa Nicholson 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 Alisa Nicholson was last updated on April 30, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Dr. Alisa Kourtney Nicholson, OD · NPI 1790186211
Optometrist provider in Douglasville, Georgia. Individual provider, active in the CMS NPPES registry since September 16, 2014.
## Identity
- **NPI:** 1790186211 (Entity type: Individual)
- **Enumerated:** September 16, 2014
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **State license:** OPT002881 (Georgia)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 6700 DOUGLAS BLVD STE 1270, Douglasville, GA 30135
- **Phone:** (770) 942-9827
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** Infocus Eye Care, Inc. (NPI 1023517471, Douglasville, GA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Illinois College Of Optometry At Chicago, class of 2014
## Record status
- **NPPES last updated:** April 30, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1790186211) · Data from the CMS NPPES public registry.