Individual provider Active NPI

Diana Vega Hernandez, OD

  • Optometrist
  • Glendale, AZ
National Provider Identifier
1013211598
Registry record updated Dec 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1784 Issued in AZ
Practice address
7260 W Bell Rd
Glendale, AZ 85308-8539
Phone
(623) 486-1888
Fax
(623) 486-8001
NPI assigned
Dec 27, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1784 AZ Primary
Optometrist 152W00000X OPC4536 FL

Addresses

Primary practice location

7260 W Bell Rd
Glendale, AZ 85308-8539

Mailing address

1021 W Horseshoe Ave
Gilbert, AZ 85233-5265
Phone (480) 276-9983

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20110920000394 AZ Practitioner - Optometry 7911178116 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Nova Southeastern Univ College of Dental Medicine, 2010
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

2475 S Val Vista Dr
Suite 103
Gilbert, AZ 85295-1214
Phone (480) 739-9445

937 N Dobson Rd
Suite 102
Mesa, AZ 85201-7589
Phone (480) 649-6100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1784AZMDOptometrist
OPC4536FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Family First Vision Care Arizona PLLC Optometrist CurrentSince Jun 5, 2018 Accepting new patients
Family First Vision Care Arizona PLLC Optometrist CurrentSince Jun 5, 2018 Accepting new patients

Locations

2475 S Val Vista Dr
Ste 103
Gilbert, AZ 85295
Phone (480) 739-9445

937 N Dobson Rd
Ste 102
Mesa, AZ 85201
Phone (480) 649-6100

316 S Hamilton Rd
Gahanna, OH 43230

Networks

  • NM HMO C-SNP

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1293408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293408000000",
    "number": "1013211598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W HORSESHOE AVE",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852335265",
            "telephone_number": "480-276-9983",
            "fax_number": "480-892-7580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7260 W BELL RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088539",
            "telephone_number": "623-486-1888",
            "fax_number": "623-486-8001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEGA HERNANDEZ",
        "first_name": "DIANA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-27",
        "last_updated": "2010-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1784",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4536",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.