Individual provider Active NPI

Darlene Michelle Fidler, O.D.

  • Optometrist
  • Corona, CA
National Provider Identifier
1861423964
Registry record updated Jan 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11352T Issued in CA
Practice address
2791 Green River Rd Ste 106
Corona, CA 92882-7453
Phone
(951) 736-2020
Fax
(951) 736-2002
NPI assigned
Jul 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 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 11352T CA Primary

Addresses

Primary practice location

2791 Green River Rd Ste 106
Corona, CA 92882-7453

Mailing address

PO Box 15415
Irvine, CA 92623-5415
Phone (714) 508-7400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20041020000839 CA Practitioner - Optometry 1759342058 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11352CAMDMental Health Counselor
11352TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Clinicas del Camino Real Inc CurrentSince Feb 1, 2016 Accepting new patients
Clinicas del Camino Real Inc Current Accepting new patients
Clinicas del Camino Real Inc CurrentSince Feb 1, 2016 Accepting new patients
Luxottica of America Inc. Past Accepting new patients
Luxottica of America Inc Past Accepting new patients
Seth Bernstein OD and Lisa Benham OD Inc Optometrist PastSince Apr 27, 2007 Accepting new patients

Locations

500 E Main St
Santa Paula, CA 93060
Phone (805) 933-0895

200 S Wells Rd
Ste 200
Ventura, CA 93004
Phone (805) 647-6322

200 S Wells Rd
Ventura, CA 93004
Phone (805) 647-6322

Interoperability endpoints

  • Direct secure messaging: darlene.fidler.p1@direct.clinicas.nextgenshare.com

Organizations & group practices 6

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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453766400000",
    "number": "1861423964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15415",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926235415",
            "telephone_number": "714-508-7400",
            "fax_number": "714-508-7408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2791 GREEN RIVER RD STE 106",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928827453",
            "telephone_number": "951-736-2020",
            "fax_number": "951-736-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIDLER",
        "first_name": "DARLENE",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2016-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11352T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

Verify at the official NPI Registry.