Active NPI
Quint Di Giacomo, O.D.
- Optometrist
- Gallup, NM
National Provider Identifier
1598889891
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OP2281
- Practice address
- 112 W Hill Ave
Gallup, NM 87301-6218 - Phone
- (505) 722-2289
- Fax
- (505) 726-6208
- NPI assigned
- Mar 19, 2007
- Last updated
- Mar 1, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OP2281 | NM | Primary |
| Optometrist | 152W00000X | 01246 | AZ |
Addresses
Primary practice location
112 W Hill Ave
Gallup, NM 87301-6218
Mailing address
10025 E Dynamite Blvd Ste 115
Scottsdale, AZ 85262-3688
Phone (480) 419-7778
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P0516 | Medicaid | NM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101028000997 | AZ | Practitioner - Optometry | 3779777271 | Practice locations: Scottsdale, AZ |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01246 | AZ | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1298937600000",
"number": "1598889891",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10025 E DYNAMITE BLVD STE 115",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852623688",
"telephone_number": "480-419-7778",
"fax_number": "480-419-7779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "112 W HILL AVE",
"city": "GALLUP",
"state": "NM",
"postal_code": "873016218",
"telephone_number": "505-722-2289",
"fax_number": "505-726-6208"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DI GIACOMO",
"first_name": "QUINT",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-19",
"last_updated": "2011-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NM",
"license": "OP2281",
"primary": true
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "AZ",
"license": "01246",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "P0516",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gallup, NM
- DHHS,PHS,Naihs, Gallup Indian Medical Center
- DHHS,PHS,Naihs,Gallup Indian Medical Center (McKinley Manor)
- DHHS,PHS,Naihs,Gallup Indian Medical Center (Red Rock Care Center)
- DHHS,PHS,Naihs,Gallup Indian Medical Center (Little Sisters Of The Poor of New Mexico, Inc.)
- DHHS,PHS,Naihs,Gallup Indian Medical Center (Rmchcs)
- Claudia Yvette Diaz, RN
- Sylvia Adell Diaz, RN
- Abbie Dickerson
- Karen Dilorenzo-Jones, BSN, ADN
- Daryl Katherine Dineyazhe-Toya, PHARMD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2011; 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.