Individual provider Active NPI

Diana Serdah, OD

  • Optometrist
  • Montrose, NY
National Provider Identifier
1518691062
Registry record updated Jul 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV009561-01 Issued in NY
Practice address
2094 Albany Post Rd
Montrose, NY 10548-1454
Phone
(914) 737-4400
NPI assigned
Jul 11, 2022
Last updated
Jul 11, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV009561-01 NY Primary

Addresses

Primary practice location

2094 Albany Post Rd
Montrose, NY 10548-1454

Mailing address

2094 Albany Post Rd
Montrose, NY 10548-1454

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
I20231103001240 NY Practitioner - Optometry 9335596964 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Middletown Medical PCGroup PAC ID 2567464308, 177 clinicians

Practice addresses (Care Compare)

111 Maltese Dr
Middletown, NY 10940-2115
Phone (845) 342-4774

Merit-based Incentive Payment System (MIPS)

Final score
84.92 of 100Reported as group
Quality
68.46
Promoting interoperability
99
Improvement activities
40
Cost
77.61

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV009561-01NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Middletown Medical PC CurrentSince Sep 11, 2023 Accepting new patients
Middletown Medical PC CurrentSince Sep 11, 2023 Accepting new patients

Locations

111 Maltese Dr
Middletown, NY 10940

419 E Main St
Middletown, NY 10940
Phone (845) 341-0213

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1657497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657497600000",
    "number": "1518691062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2094 ALBANY POST RD",
            "city": "MONTROSE",
            "state": "NY",
            "postal_code": "105481454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2094 ALBANY POST RD",
            "city": "MONTROSE",
            "state": "NY",
            "postal_code": "105481454",
            "telephone_number": "914-737-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERDAH",
        "first_name": "DIANA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-11",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV009561-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montrose, NY

Sources for this page

Verify at the official NPI Registry.