Individual provider Active NPI

Diana Arredondo, OD

  • Optometrist
  • Saint Paul, MN
National Provider Identifier
1821782913
Registry record updated Apr 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3921 Issued in MN
Practice address
409 Dunlap St N
Saint Paul, MN 55104-4201
Phone
(651) 290-9200
Fax
(651) 251-5950
NPI assigned
Jun 5, 2023
Last updated
Apr 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ODTA00573 RI
Optometrist 152W00000X 3921 MN Primary

Addresses

Primary practice location

409 Dunlap St N
Saint Paul, MN 55104-4201

Mailing address

409 Dunlap St N
Saint Paul, MN 55104-4201
Phone (651) 290-9200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20240830000072 MN Practitioner - Optometry 5597125872 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
Open Cities Health Center IncGroup PAC ID 5799696621, 12 clinicians

Practice addresses (Care Compare)

409 Dunlap St N
Saint Paul, MN 55104-4201
Phone (651) 290-9211

916 Rice St
Saint Paul, MN 55117-5425
Phone (651) 290-9211

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3921MNMDOptometrist
ODTA00573RIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Open Cities Health Center, Inc. Current Accepting new patients
Open Cities Health Center, Inc. CurrentSince Jul 29, 2024 Accepting new patients
Open Cities Health Center, Inc. CurrentSince Jul 29, 2024 Accepting new patients

Locations

409 Dunlap St N
Saint Paul, MN 55104
Phone (651) 290-9200

916 Rice St
Saint Paul, MN 55117
Phone (651) 290-9200

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IDHIBD

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, 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": "1685923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744934400000",
    "number": "1821782913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 DUNLAP ST N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551044201",
            "telephone_number": "651-290-9200",
            "fax_number": "651-251-5950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 DUNLAP ST N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551044201",
            "telephone_number": "651-290-9200",
            "fax_number": "651-251-5950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARREDONDO",
        "first_name": "DIANA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-05",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "RI",
            "license": "ODTA00573",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.