Individual provider Active NPI

Diana Mihaela Ciobanu, O.D.

  • Optometrist
  • Mission Viejo, CA
National Provider Identifier
1013002179
Registry record updated May 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT12974TPA Issued in CA
Practice address
602 The Shops at Mission Viejo
Mission Viejo, CA 92691-6515
Phone
(949) 582-2020
Fax
(949) 364-1837
NPI assigned
Oct 4, 2006
Last updated
May 1, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT12974TPA CA Primary

Addresses

Primary practice location

602 The Shops at Mission Viejo
Mission Viejo, CA 92691-6515

Mailing address

602 The Shops at Mission Viejo
Mission Viejo, CA 92691-6515
Phone (949) 582-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060407000405 CA Practitioner - Optometry 6608885330 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT12974TPACAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Visual Paradise Optometry, Inc. Optometrist Current Accepting new patients
Luxottica of America Inc. Past Accepting new patients
Glendale Optometric Center Optometrist PastSince Jul 10, 2007 Accepting new patients
Duane Decroupet OD a PC Optometrist Past Accepting new patients
Luxottica of America Inc Past Accepting new patients

Locations

13200 Jamboree Rd
Ste Optical
Irvine, CA 92602

13200 Jamboree Rd
Irvine, CA 92602
Phone (714) 368-0183

Interoperability endpoints

  • Direct secure messaging: diana.ciobanu@uprisedirect.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493596800000",
    "number": "1013002179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 THE SHOPS AT MISSION VIEJO",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916515",
            "telephone_number": "949-582-2020",
            "fax_number": "949-364-1837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 THE SHOPS AT MISSION VIEJO",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916515",
            "telephone_number": "949-582-2020",
            "fax_number": "949-364-1837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIOBANU",
        "first_name": "DIANA",
        "middle_name": "MIHAELA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2017-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT12974TPA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

Verify at the official NPI Registry.