NPIMap

Individual provider Active NPI

Sheldon D. Diskin, O.D.

  • Optometrist
  • Upper Marlboro, MD
National Provider Identifier
1598816944
Registry record updated Jul 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA0635 Issued in MD
Practice address
48 Watkins Park Dr
Upper Marlboro, MD 20774-1628
Phone
(301) 249-5890
Fax
(301) 249-5892
NPI assigned
Jan 14, 2007
Last updated
Jul 21, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA0635 MD Primary

Addresses

Primary practice location

48 Watkins Park Dr
Upper Marlboro, MD 20774-1628

Mailing address

7931 Ritchie Hwy
Glen Burnie, MD 21061-4343
Phone (410) 768-8830

Other identifiers 2

IdentifierTypeStateIssuer
X156OtherMDCARE FIRST
6803OtherMDCARE FIRST NATIONAL CAPIT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Alexander C Nnabue and Associates PA Past Accepting new patients
PD Optics Inc. T/a Pearle Vision Center PastSince Oct 6, 2019 Accepting new patients

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": "1168732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469059200000",
    "number": "1598816944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7931 RITCHIE HWY",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210614343",
            "telephone_number": "410-768-8830",
            "fax_number": "410-768-2219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 WATKINS PARK DR",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207741628",
            "telephone_number": "301-249-5890",
            "fax_number": "301-249-5892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISKIN",
        "first_name": "SHELDON",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-14",
        "last_updated": "2016-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA0635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE FIRST",
            "identifier": "X156",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE FIRST NATIONAL CAPIT",
            "identifier": "6803",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Upper Marlboro, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.