Individual provider Active NPI

Delma Faria Zardo, OD

  • Optometrist
  • Modesto, CA
National Provider Identifier
1306861612
Registry record updated Jul 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT12678T Issued in CA
Practice address
810 Standiford Ave Ste 4
Modesto, CA 95350-0977
Phone
(209) 524-7870
Fax
(209) 524-7985
NPI assigned
Jul 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT12678T CA Primary

Addresses

Primary practice location

810 Standiford Ave Ste 4
Modesto, CA 95350-0977

Mailing address

2421 Kiska Dr
Modesto, CA 95355-7913
Phone (209) 605-0442

Other identifiers 1

IdentifierTypeStateIssuer
SD0126780MedicaidCA

Other names 1

  • Ms. Delma Goulart Faria Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20070119000176 CA Practitioner - Optometry 6204837198 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

810 Standiford Ave
Suite 4
Modesto, CA 95350-0977
Phone (209) 605-0442

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT12678TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy & Young Optometry Optometrist CurrentSince Jun 22, 2021 Accepting new patients
Delma F Zardo OD a Professional Optometric Corporation Optometrist CurrentSince Dec 16, 2020 Accepting new patients

Locations

810 Standiford Ave
Ste 4
Modesto, CA 95350
Phone (209) 524-7870

1317 Oakdale Rd
Ste 620
Modesto, CA 95355
Phone (209) 524-7870

1401 Sylvan Ave
Modesto, CA 95355
Phone (209) 527-6640

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1306861612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2421 KISKA DR",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953557913",
            "telephone_number": "209-605-0442",
            "fax_number": "209-524-7985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 STANDIFORD AVE STE 4",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953500977",
            "telephone_number": "209-524-7870",
            "fax_number": "209-524-7985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZARDO",
        "first_name": "DELMA",
        "middle_name": "FARIA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2021-07-14",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT12678T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0126780",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DELMA",
            "last_name": "FARIA",
            "middle_name": "GOULART",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.