Individual provider Active NPI

Vicente Antonio Diaz, MD

  • Uveitis and Ocular Inflammatory Disease (Ophthalmology) Physician
  • Stratford, CT
National Provider Identifier
1114190154
Registry record updated Jan 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Uveitis and Ocular Inflammatory Disease (Ophthalmology) PhysicianTaxonomy code 207WX0108X
License
048651 Issued in CT
Practice address
495 Hawley LN
Stratford, CT 06614-1514
Phone
(203) 375-5819
NPI assigned
Apr 10, 2008
Last updated
Jan 30, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 251919 NY
Uveitis and Ocular Inflammatory Disease (Ophthalmology) Physician 207WX0108X 048651 CT Primary

Addresses

Primary practice location

495 Hawley LN
Stratford, CT 06614-1514

Mailing address

495 Hawley LN
Stratford, CT 06614-1514
Phone (203) 375-5819

Other practice location 1

310 E 14th St
Suite 319
New York, NY 10003-4201
Phone (212) 979-4500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101130000349 CT Practitioner - Ophthalmology 5092851188 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Yale University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

40 Temple St
Suite 3a
New Haven, CT 06510-2715
Phone (203) 785-2020

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.36 of 100Reported as group
Quality
77.36
Promoting interoperability
100
Improvement activities
40
Cost
74.27

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery32

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
048651CTMDUveitis and Ocular Inflammatory Disease (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optimus Health Care Inc CurrentSince Aug 1, 2012 Accepting new patients
Yale University CurrentSince Apr 1, 2019 Accepting new patients
Yale University Ophthalmology CurrentSince Apr 1, 2019 Accepting new patients

Locations

982 E Main St
Bridgeport, CT 06608
Phone (203) 696-3260

471 Barnum Ave
Bridgeport, CT 06608
Phone (203) 333-6864

40 Temple St
Ste 3A
New Haven, CT 06510
Phone (203) 785-2020

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

46 Prince St
Ste 404
New Haven, CT 06519
Phone (203) 785-1755

50 Division St
New Haven, CT 06511
Phone (203) 785-2140

495 Hawley Ln
Stratford, CT 06614
Phone (203) 375-5819

Interoperability endpoints

  • Direct secure messaging: vdiaz5868@direct.ynhh.org

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548806400000",
    "number": "1114190154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 HAWLEY LN",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066141514",
            "telephone_number": "203-375-5819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 HAWLEY LN",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066141514",
            "telephone_number": "203-375-5819"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "310 E 14th St",
            "address_2": "Suite 319",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100034201",
            "country_code": "US",
            "telephone_number": "212-979-4500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "VICENTE",
        "middle_name": "ANTONIO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-10",
        "last_updated": "2019-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "251919",
            "primary": false
        },
        {
            "code": "207WX0108X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Uveitis and Ocular Inflammatory Disease",
            "state": "CT",
            "license": "048651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stratford, CT

Sources for this page

Verify at the official NPI Registry.