Kristin Difuntorum, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1072 Issued in NV

Practice address

230 N Nellis Blvd Ste B
Las Vegas, NV 89110-6003

Phone

(702) 360-8070

NPI assigned

Jul 29, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

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

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.

• Aloha Vision LLC

  • Optometrist
  • Las Vegas, NV
  • NPI 1841923349
  Medicare reassignment NPD
• Girisgen & Kopolow OD, PC

  • Optometrist
  • Las Vegas, NV
  • NPI 1427382415
  Medicare reassignment NPD
• Kopolow & Girisgen Professional Corporation

  • Optometrist
  • Las Vegas, NV
  • NPI 1518904622
  Medicare reassignment NPD
• Girisgen & Kopolow OD, PC

  • Optometrist
  • Las Vegas, NV
  • NPI 1457716391
  NPD
• Girisgen & Kopolow OD, PC

  • Optometrist
  • Las Vegas, NV
  • NPI 1841523164
  NPD

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

{
    "created_epoch": "1595980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1407465057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 SANTA FE ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891455327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 N NELLIS BLVD STE B",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891106003",
            "telephone_number": "702-360-8070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIFUNTORUM",
        "first_name": "KRISTIN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-29",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "1072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valleyry Cardine Dieujuste
• Rachel Diez
• Thierry Diez
• Gina Difilippi
• Samantha Elizabeth Difulvio
• Kristine Digal
• Gamaliel Digan
• Shanita Digby
• Digestive Disease Center
• Digestive Disease Center

• Optometrist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Optometrist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.