Perin W Diana Jr., MD
Individual provider Active NPI Ophthalmology Physician · Varnville, SC
NPI 1295791598 · NPPES record last updated Oct 13, 2016
Key facts
- NPI
- 1295791598
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Ophthalmology Physician 207W00000X
- License
- 20809 (SC)
- Practice address
- 1000 Pine Street
Varnville, SC 29944-0969 - Phone
- (803) 943-5228
- Fax
- (803) 943-4591
- NPI assigned
- Apr 25, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Ophthalmology
- Education
- Perelman School of Med at the University of Pennsylvania, 1969
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Beaufort Eye Center P a
Practice addresses (Care Compare)
1664 Ribaut Rd
Port Royal, SC 29935-1708
Phone (843) 522-8466
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in SC, CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071207000356 | SC | Practitioner - Ophthalmology | 9537258959 | Reassigns benefits to 1 organization |
| I20120315000138 | CT | Practitioner - Ophthalmology | 9537258959 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beaufort Eye Optical | Ophthalmology | Current |
Accepting new patients |
| Palmetto Eye Specialists, P.a. | Ophthalmology | Past |
Accepting new patients |
| Sungate Medical Group LLC | Ophthalmology | Past | Accepting new patients |
| University Medical Associates of the Medical University of South Carol | Past | Accepting new patients |
Locations
1664 Ribaut Rd
Port Royal, SC 29935
Phone (843) 522-8466
Interoperability endpoints
- pdiana@bec.intellechartdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 20809 | SC | Yes |
Addresses
Primary practice location
1000 Pine Street
Varnville, SC 29944-0969
Mailing address
55 Meriden Ave
Ste 2D
Southington, CT 06489-3235
Phone (843) 726-6509
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GP0365 | Medicaid | SC | |
| 570669239-001 | Other | SC | BLUE CROSS |
| T49310 | Medicaid | SC | |
| 570669239-002 | Other | SC | BLUE CHOICE |
Other providers in Varnville, SC
- Vicki Lynn Chassereau
- Coastal Plains Physician Associates
- Kayla Stroble Colson
- Comfort to You
- Joseph Crawford III
- Melvin Dubard Jr.
- Earl B Hartzog DMD PA
- Eg DMD, LLC
- Felicia Jonelle Ferguson
- Alfare Fields
All providers in Varnville, SC · Ophthalmology Physician in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 13, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.