Individual provider Active NPI

Diane J Nelson, OD

  • Optometrist
  • Derry, NH
National Provider Identifier
1861579070
Registry record updated Nov 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0499 Issued in NH
Practice address
55 Crystal Ave
Hood Commons
Derry, NH 03038-1702
Phone
(603) 434-2020
Fax
(603) 437-1260
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0499 NH Primary

Addresses

Primary practice location

55 Crystal Ave
Hood Commons
Derry, NH 03038-1702

Mailing address

55 Crystal Ave
Hood Commons
Derry, NH 03038-1702
Phone (603) 434-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20051022000068 NH Practitioner - Optometry 0042236614 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Care Associates of Derry PCGroup PAC ID 6305881574, 2 clinicians
Capital Vision Center PCGroup PAC ID 1052320660, 7 clinicians

Practice addresses (Care Compare)

55 Crystal Ave
Derry, NH 03038-1702
Phone (603) 434-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0499NHMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Vision Center PC Optometrist CurrentSince Jan 1, 2026 Accepting new patients
Eye Care Associates of Derry PC Optometrist CurrentSince May 10, 1990 Accepting new patients
Cornerstone Periodontics and Implants PLLC PastSince Apr 1, 2021 Accepting new patients

Locations

55 Crystal Ave
Derry, NH 03038
Phone (603) 434-2020

55 Crystal Ave
Unit 26
Derry, NH 03038
Phone (603) 226-0855

Interoperability endpoints

  • Direct secure messaging: drnelson@emeryeye.eyefinity-direct.com

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194307200000",
    "number": "1861579070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 CRYSTAL AVE",
            "address_2": "HOOD COMMONS",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "030381702",
            "telephone_number": "603-434-2020",
            "fax_number": "603-437-1260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 CRYSTAL AVE",
            "address_2": "HOOD COMMONS",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "030381702",
            "telephone_number": "603-434-2020",
            "fax_number": "603-437-1260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "DIANE",
        "middle_name": "J",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NH",
            "license": "0499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Derry, NH

Sources for this page

Verify at the official NPI Registry.