DR. NICOLE L AMIDON O.D.
NPI 1992762835
Optometrist in Fond Du Lac, 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 December 21, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.

Active since April 26, 2006PECOS EnrolledAccepts Medicare Assignment

459 W JOHNSON ST, FOND DU LAC, WI 54935(920) 922-5990 Get Directions Write a Review

NPPES record last updated: December 21, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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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 Fond Du Lac, 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 Address459 W JOHNSON STFond Du Lac, WI 54935-3170

Mailing Address16800 West Cleveland AveNew Berlin, WI 53151-3533 · (262) 432-2005

Phone(920) 922-5990

Sole ProprietorNo

Medical School CMSFerris State College - College Of OptometryGraduated 1999

Enumeration DateApril 26, 2006

Last NPPES UpdateDecember 21, 2007

✔ 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.

459 W JOHNSON ST, Fond Du Lac, WI 54935

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Other Names 1

Former Name (1)Miss Nicole Lynn Boudry

Other Identifiers 3

Medicaid38611200WI

OtherWI2758Eyemed Vision No.

Medicare UPINU81736WI

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, and ordering and referring status from the CMS PECOS system.

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54935 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 2

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

WISCONSIN VISION, LLC

Optometrist

459 W JOHNSON ST
FOND DU LAC, WI 54935

Fond Du Lac County (920) 922-5990

JACK LUND

Optometrist

459 W JOHNSON ST
FOND DU LAC, WI 54935

Fond Du Lac County (920) 922-5990

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 459 W Johnson St, Fond Du Lac, WI 54935. The listed phone number is (920) 922-5990.

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.

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 December 21, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.