Active NPI
Diana Stewart, O.D.
- Optometrist
- Okemos, MI
National Provider Identifier
1104129626
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4901004614
- Practice address
- 2333 Jolly Rd
Okemos, MI 48864-3541 - Phone
- (517) 381-2000
- NPI assigned
- Dec 6, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4901004614 | MI | Primary |
Addresses
Primary practice location
2333 Jolly Rd
Okemos, MI 48864-3541
Mailing address
5210 Twinging Dr
Okemos, MI 48864-2977
Phone (908) 305-2514
Other practice location 1
5403 W Saginaw Hwy
Lansing, MI 48917-1918
Phone (517) 886-0222
Other names 1
- Diana Colon
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160715000810 | MI | Practitioner - Optometry | 6103118807 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bennett Optometry LLC | Optometrist | Current | Accepting new patients |
Organizations & group practices 1
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": "1291593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632700800000",
"number": "1104129626",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5210 TWINGING DR",
"city": "OKEMOS",
"state": "MI",
"postal_code": "488642977",
"telephone_number": "908-305-2514"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2333 JOLLY RD",
"city": "OKEMOS",
"state": "MI",
"postal_code": "488643541",
"telephone_number": "517-381-2000"
}
],
"practiceLocations": [
{
"address_1": "5403 W Saginaw Hwy",
"address_purpose": "LOCATION",
"city": "Lansing",
"state": "MI",
"postal_code": "489171918",
"country_code": "US",
"telephone_number": "517-886-0222",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STEWART",
"first_name": "DIANA",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-12-06",
"last_updated": "2021-09-27",
"certification_date": "2021-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MI",
"license": "4901004614",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "DIANA",
"last_name": "COLON",
"credential": "O.D.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Okemos, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.