Individual provider Active NPI

Diana E Dracopoulos, O.D.

  • Optometrist
  • Milwaukee, WI
National Provider Identifier
1639227176
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4054-35 Issued in WI
Practice address
315 N Broadway
Milwaukee, WI 53202-5879
Phone
(414) 253-1812
NPI assigned
Jan 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046-009479 IL
Optometrist 152W00000X 2469 SC
Optometrist 152W00000X 4054-35 WI Primary

Addresses

Primary practice location

315 N Broadway
Milwaukee, WI 53202-5879

Mailing address

315 N Broadway
Milwaukee, WI 53202-5879
Phone (414) 253-1812

Other names 1

  • Diana E Phillips Miranda Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20110113000160 IL Practitioner - Optometry 5597954180 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vep Il Optometric LLCGroup PAC ID 3678814217, 27 clinicians

Practice addresses (Care Compare)

5255 State Route 251
Peru, IL 61354-1005
Phone (815) 224-2700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046-009479ILMDOptometrist
4054-35WIMDOptometrist
2469SCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vep Il Optometric LLC Optometrist CurrentSince May 1, 2024 Accepting new patients
Warby Parker Inc. PastSince May 25, 2025 Accepting new patients
Oneopto Il 2 PLLC Optometrist PastSince Sep 28, 2025 Accepting new patients

Locations

101 N Veterans Pkwy
Ste 301
Bloomington, IL 61704
Phone (309) 663-2700

2201 Sycamore Rd
DeKalb, IL 60115
Phone (815) 754-2020

5255 State Route 251
Peru, IL 61354
Phone (815) 224-2700

4304 E Lincolnway
Ste D
Sterling, IL 61081
Phone (815) 626-2020

811 Main St
Kansas City, MO 64180

Organizations & group practices 3

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": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1639227176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 N BROADWAY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532025879",
            "telephone_number": "414-253-1812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 N BROADWAY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532025879",
            "telephone_number": "414-253-1812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRACOPOULOS",
        "first_name": "DIANA",
        "middle_name": "E",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-009479",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "2469",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "4054-35",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANA",
            "last_name": "PHILLIPS MIRANDA",
            "middle_name": "E",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.