Individual provider Active NPI

Diane D Luu, O.D.

  • Optometrist
  • Braden River, FL
National Provider Identifier
1255414710
Registry record updated May 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 4411 Issued in FL
Practice address
2911 53Rd Ave E
Braden River, FL 34203-4312
Phone
(941) 752-0802
Fax
(941) 752-2084
NPI assigned
Oct 20, 2006
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20160119001491 FL Practitioner - Optometry 7214230614 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC 4411FLMDOptometrist
6899TXMDOptometrist

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6899 TX
Optometrist 152W00000X OPC 4411 FL Primary

Addresses

NPPES NPI Registry

Primary practice location

2911 53Rd Ave E
Braden River, FL 34203-4312

Mailing address

2911 53Rd Ave E
Braden River, FL 34203-4312
Phone (941) 752-0802

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 7, 2015.

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430956800000",
    "number": "1255414710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2911 53RD AVE E",
            "city": "BRADEN RIVER",
            "state": "FL",
            "postal_code": "342034312",
            "telephone_number": "941-752-0802",
            "fax_number": "941-752-2084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2911 53RD AVE E",
            "city": "BRADEN RIVER",
            "state": "FL",
            "postal_code": "342034312",
            "telephone_number": "941-752-0802",
            "fax_number": "941-752-2084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUU",
        "first_name": "DIANE",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2015-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6899",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 4411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Braden River, FL

Sources for this page

Verify at the official NPI Registry.