Lu'Aie Husam Dia, STUDENT

Primary specialty

OptometristTaxonomy code 152W00000X

License

3257 Issued in OK

Practice address

1001 N Grand Ave
Tahlequah, OK 74464-7017

Phone

(918) 444-4031

NPI assigned

Mar 27, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, WY2 enrollments

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 2

Specialty

Optometry

Education

Pacific University - College of Optometry, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gillette Optometric Clinic PCGroup PAC ID 3870507221, 6 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Gillette Optometric Clinic PC

  • Corneal and Contact Management Optometrist
  • Gillette, WY
  • NPI 1891850707
  Medicare reassignment Care Compare group NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Sallisaw, OK
  • NPI 1780692723

  TX

  Medicare reassignment NPD
• Cherokee Nation

  • Public Health or Welfare Agency
  • Tahlequah, OK
  • NPI 1013884154
  NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Jay, OK
  • NPI 1659388965
  NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Muskogee, OK
  • NPI 1841207156
  NPD
• Cherokee Nation

  • General Acute Care Hospital
  • Tahlequah, OK
  • NPI 1275799645
  NPD (past)

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

{
    "created_epoch": "1711497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1194576215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "772 NE AUTUMNCREEK WAY APT O208",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "970068743",
            "telephone_number": "806-674-7661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 N GRAND AVE",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744647017",
            "telephone_number": "918-444-4031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIA",
        "first_name": "LU'AIE",
        "middle_name": "HUSAM",
        "credential": "STUDENT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-27",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "3257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher S Deloache, D.O.
• Denise Lagrand, Psy.D., LLC
• Tate Dennis
• Nancy Ellen Denton, APRN-CNP
• Carl Joseph Depaula, M.D.
• Jacob Edward Dickerson, DNAP
• Kielan Dietrich, DMD
• Audrey Dietz
• Mallorre Raeschell Dill, O.D.
• Anthony Dirteater

• Optometrist in Tahlequah, OK
• Providers in Tahlequah, OK by specialty
• Optometrist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.