Maria I Diaz, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2426 Issued in CT

Practice address

64 Thompson St
Suite B104
East Haven, CT 06513-5707

Phone

(203) 469-1012

Fax

(203) 467-1369

NPI assigned

Feb 28, 2006

Last updated

Oct 2, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

New England College of Optometry, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Connecticut Vision Center, LLCGroup PAC ID 0446390462, 2 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Connecticut Vision Center, LLC

  • Optometrist
  • East Haven, CT
  • NPI 1942459615
  Medicare reassignment Care Compare group NPD Authorized official
• Madison Eye Care LLC

  • Low Vision Rehabilitation Optometrist
  • Madison, CT
  • NPI 1144235847
  NPD (past)

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349136000000",
    "number": "1265408371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 THOMPSON ST",
            "address_2": "SUITE B104",
            "city": "EAST HAVEN",
            "state": "CT",
            "postal_code": "065135707",
            "telephone_number": "203-469-1012",
            "fax_number": "203-467-1369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 THOMPSON ST",
            "address_2": "SUITE B104",
            "city": "EAST HAVEN",
            "state": "CT",
            "postal_code": "065135707",
            "telephone_number": "203-469-1012",
            "fax_number": "203-467-1369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "MARIA",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-28",
        "last_updated": "2012-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "2426",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "090002426CT12",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004173598",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "544893",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marc Denigris, O.D.
• Christy Ann Derosa, LCSW
• Daniela Deslouches
• Kristina Detweiler
• Michelle Devellis
• Ann Celeste Mapas Dimaya, M.D.
• Alison Theresa Dipalma, PT
• Docs Medical Inc
• Dr. Dental of East Haven, PC
• Susan Dudley, PTA

• Optometrist in East Haven, CT
• Providers in East Haven, CT by specialty
• Optometrist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2012; 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.