Individual provider Active NPI

Michael S Diamond, O.D.

  • Optometrist
  • Evans Mills, NY
National Provider Identifier
1467460535
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV3148NYS Issued in NY
Practice address
25737 US Route 11
Evans Mills, NY 13637-3221
Phone
(315) 629-4312
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV3148NYS NY Primary

Addresses

Primary practice location

25737 US Route 11
Evans Mills, NY 13637-3221

Mailing address

6510 Stage Rd
Utica, NY 13502-6714
Phone (315) 865-4299

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20040825000490 NY Practitioner - Optometry 3971577271 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV3148NYSNYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Empire Vision Center Inc Optometrist CurrentSince Apr 30, 2021 Accepting new patients
Empire Vision Center, Inc CurrentSince Apr 30, 2021 Accepting new patients
Eye Designs Unlimited Optometry PC Optometrist PastSince Nov 12, 2012 Accepting new patients
Great View Inc Past Accepting new patients

Locations

2680 Delaware Ave
Ste C
Buffalo, NY 14216
Phone (716) 873-1241

8511 126th St
Kew Gardens, NY 11415
Phone (718) 849-7773

560 Troy Schenectady Rd
#7
Latham, NY 12110
Phone (518) 783-0090

1930 South Rd
#105
Poughkeepsie, NY 12601
Phone (845) 298-3200

2590 W Ridge Rd
Rochester, NY 14626
Phone (585) 227-7150

2921 Erie Blvd E
Syracuse, NY 13224
Phone (315) 446-3145

Organizations & group practices 4

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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1467460535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6510 STAGE RD",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135026714",
            "telephone_number": "315-865-4299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25737 US ROUTE 11",
            "city": "EVANS MILLS",
            "state": "NY",
            "postal_code": "136373221",
            "telephone_number": "315-629-4312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAMOND",
        "first_name": "MICHAEL",
        "middle_name": "S",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV3148NYS",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evans Mills, NY

Sources for this page

Verify at the official NPI Registry.