Individual provider Active NPI

Diane E Calderon-Villanueva, O.D.

  • Optometrist
  • New York, NY
National Provider Identifier
1093780827
Registry record updated Oct 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV 006768-1 Issued in NY
Practice address
33 W 42ND St
New York, NY 10036-8005
Phone
(212) 389-4001
Fax
(212) 938-5831
NPI assigned
Feb 23, 2006
Last updated
Oct 2, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC 3876 FL
Optometrist 152W00000X TUV 006768-1 NY Primary

Addresses

Primary practice location

33 W 42ND St
New York, NY 10036-8005

Mailing address

6254 97TH PL
Apt 8E
Rego Park, NY 11374-1346
Phone (917) 553-2541

Other identifiers 2

IdentifierTypeStateIssuer
620967000MedicaidFL
03231078MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20090727000454 NY Practitioner - Optometry 8426962911 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2003
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

33 W 42ND St
New York, NY 10036-8005
Phone (212) 938-4001

Merit-based Incentive Payment System (MIPS)

Final score
86.46 of 100Reported as group
Quality
73.89
Promoting interoperability
89
Improvement activities
40
Cost
75.72

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC 3876FLMDOptometrist
TUV 006768-1NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
State of New York Comptrollers Office Optometrist CurrentSince May 31, 2018 Accepting new patients
State of New York Comptrollers Office CurrentSince May 31, 2018 Accepting new patients
Mark Fromer, MD PC PastSince Jul 1, 2009 Accepting new patients

Locations

33 W 42nd St
New York, NY 10036
Phone (212) 780-4930

33 W 42nd St
Fl 10
New York, NY 10036
Phone (212) 780-4930

University Eye Ctr
New York, NY 10087

Interoperability endpoints

  • Direct secure messaging: diane.calderon.p1@direct.opt.nextgenshare.com

Organizations & group practices 3

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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538438400000",
    "number": "1093780827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6254 97TH PL",
            "address_2": "APT 8E",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113741346",
            "telephone_number": "917-553-2541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 W 42ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100368005",
            "telephone_number": "212-389-4001",
            "fax_number": "212-938-5831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDERON-VILLANUEVA",
        "first_name": "DIANE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-23",
        "last_updated": "2018-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 3876",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV 006768-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620967000",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03231078",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.