Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. NICOLE L AMIDON O.D.
NPI 1992762835
Optometrist in Hartford, WI

Q: What is Nicole Amidon's NPI number?

The NPI number for Nicole Amidon is 1992762835. It was assigned to this individual provider in the NPPES registry on April 26, 2006. The provider is also known as Miss Nicole Lynn Boudry.

Q: What is Nicole Amidon's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Nicole Amidon was last updated on October 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 days 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.

Active since April 26, 2006PECOS EnrolledAccepts Medicare Assignment

1595 E SUMNER ST STE 108, HARTFORD, WI 53027(262) 709-8211(262) 397-8610 Get Directions Write a Review

NPPES record last updated: October 15, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Dr. Nicole L Amidon O.d. NPPES

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

DR. NICOLE L AMIDON O.D. (NPI 1992762835) is an individual optometrist in Hartford, Wisconsin, licensed in Wisconsin (2758-.035) and active in the NPI registry since April 2006. She is enrolled in Medicare PECOS and is a graduate of Ferris State College - College Of Optometry (1999).

NPPES Registry Identity

NPI1992762835

Entity TypeIndividualFemale

Primary Taxonomy152W00000X

Provider Legal NameDR. NICOLE L AMIDONCredential: O.D.

Location Address1595 E SUMNER ST STE 108Hartford, WI 53027-2691

Mailing Address1595 E Sumner St Ste 108Hartford, WI 53027-2691 · (262) 709-8211 · Fax (262) 397-8610

Phone(262) 709-8211

Fax(262) 397-8610

Sole ProprietorNo

Medical School CMSFerris State College - College Of OptometryGraduated 1999

Enumeration DateApril 26, 2006

Last NPPES UpdateOctober 15, 2026

NPPES CertifiedOctober 15, 2026

✔ NPI 1992762835 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 WI · 2758-.035

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.

1595 E SUMNER ST STE 108, Hartford, WI 53027

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Other Names 1

Former Name (1)Miss Nicole Lynn Boudry

Other Identifiers 3

Medicaid38611200WI

Other410045623WI · Railroad Medicare

OtherWI2758Eyemed Vision No.

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, Blue Cross and Blue Shield of Louisiana 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 and accepts Medicare assignment

Dr. Nicole L Amidon O.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 ID4082698410

PECOS Enrollment IDI20040621000041

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 Amidon reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Shoptikal LLC

Same address

Eyewear Supplier

1595 E SUMNER ST STE 108
Hartford, WI 53027

Reassigned Medicare billing, Wisconsin enrollment
187 clinicians in this Medicare group

NPI 1912598830 (262) 709-8211

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 53027 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

$123.69 typical visit price

range $53.90 – $163.24

Typical copayment $30.92 (range $13.47 – $40.81)

Most-billed visit code 99204

Established Patient

$67.37 typical visit price

range $17.40 – $133.76

Typical copayment $16.84 (range $4.35 – $33.44)

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.

Other Providers at the Same Location NPPES

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

SHOPTIKAL LLC

Eyewear Supplier

1595 E SUMNER ST STE 108
HARTFORD, WI 53027

Washington County (262) 709-8211

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 Amidon's NPI number?

The NPI number for Nicole Amidon is 1992762835. It was assigned to this individual provider in the NPPES registry on April 26, 2006. The provider is also known as Miss Nicole Lynn Boudry.

Where is Nicole Amidon located?

Nicole Amidon practices at 1595 E Sumner St Ste 108, Hartford, WI 53027. The listed phone number is (262) 709-8211.

What is Nicole Amidon's specialty?

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

Is Nicole Amidon enrolled in Medicare?

Yes. Nicole Amidon 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 Nicole Amidon's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nicole Amidon reassigns Medicare benefits to Shoptikal LLC (Hartford, WI). 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 Amidon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Nicole Amidon accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana and Blue Cross and Blue Shield of Montana and 5 other insurers list Nicole Amidon 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 Amidon was last updated on October 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 days 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.