DR. MICHAEL F DIFFENDALL (NPI# 1184667057) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184667057 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL F DIFFENDALL |
| Credential | OD |
| Practice Address |
3332 Paper Mill Rd Phoenix MD 21131-1419 |
| Mailing Address |
3714 Tudor Arms Ave Baltimore MD 21211-2246 |
| Practice Telephone | 4106281510 |
| Practice Fax Number | 4106281511 |
| Mailing Telephone | 4103660165 |
| Mailing Fax Number | 3013523568 |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2013-10-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | TA1372 | MD | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DC | BLUE CROSS CAREFIRST | 67500005 | 01 |
| MD | MAMSI | 1086642 | 01 |
| MD | 403626300 | 05 |
| Street Address |
3332 PAPER MILL RD |
| City | PHOENIX |
| State | MD |
| Zip Code | 21131-1419 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346678240 | Jacksonville Eye Care | Optometrist | 3332 Paper Mill Rd, Phoenix, MD 21131-1419 | 2013-10-31 |
| 1194074476 | M. F. Diffendall Od Pa | Optometrist | 3332 Paper Mill Rd, Phoenix, MD 21131-1419 | 2012-09-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114118387 | Mina Kirkova | Social Worker | 3009 Jackson Ridge Ct, Phoenix, MD 21131 | 2007-08-05 |
| 1629101381 | Kenneth Barry Sharoff | Social Worker | 1 Cross Creek Ct, Phoenix, MD 21131 | 2007-03-13 |
| 1508999798 | Nancy Lee Sharoff | Social Worker | 1 Cross Creek Ct, Phoenix, MD 21131 | 2007-03-14 |
| 1093977134 | Amy Ruth Rakusin | Counselor | 10 Cross Creek Ct, Phoenix, MD 21131-1000 | 2008-06-30 |
| 1932493616 | Kenneth Sharoff, Phd Inc. | Social Worker | 1 Cross Creek Ct, Phoenix, MD 21131-1000 | 2011-05-31 |
| 1063608735 | Catherine Anderson North | Radiology | 1410 Phoenix Rd W, Phoenix, MD 21131-1024 | 2007-09-17 |
| 1528482643 | Charles Warnke | Speech-Language Pathologist | 13 Stonewood Ct, Phoenix, MD 21131-1116 | 2014-02-10 |
| 1699259580 | Keith Dibenedetto | Nurse Practitioner | 2617 Stockton Rd, Phoenix, MD 21131-1117 | 2018-09-18 |
| 1952775694 | Aileen Mccausland | Occupational Therapy Assistant | 2515 Stockton Rd, Phoenix, MD 21131-1127 | 2015-11-18 |
| 1124309430 | Amanda Brady Watters Gorman | Registered Nurse | 2113 Highland Ridge Dr, Phoenix, MD 21131-1217 | 2011-08-31 |
| Find all providers in zip 21131 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689283830 | Kelsie Stevens | Optometrist | 6815 N 19th Ave Ste 130, Phoenix, AZ 85015-1135 | 2020-07-23 |
| 1134747801 | National Vision Inc | Optometrist | 1838 W Bell Rd, Phoenix, AZ 85023-3480 | 2020-07-09 |
| 1770109282 | Nathan Jones | Optometrist | 6135 N 35th Ave Ste 139, Phoenix, AZ 85017-1953 | 2020-06-20 |
| 1447874755 | Jenna Derubeis | Optometrist | 16515 S 40th St Ste 111, Phoenix, AZ 85048-0559 | 2020-06-02 |
| 1184250383 | Jhajaira Elizabeth Cadenas | Optometrist | 3937 W Northview Ave, Phoenix, AZ 85051 | 2020-03-19 |
| 1659927663 | National Vision Inc | Optometrist | 2805 W Agua Fria Fwy Ste 1, Phoenix, AZ 85027-3940 | 2019-08-15 |
| 1588148993 | Jillian Ralston | Optometrist | 112 W Mcdowell Road, Phoenix, AZ 85003 | 2018-09-20 |
| 1932680618 | Carefree Eyecare | Optometrist | 3170 W Carefree Hwy Ste C3c4, Phoenix, AZ 85086-3205 | 2018-08-22 |
| 1710464417 | Ngoc Le | Optometrist | 1650 E Camelback Rd Ste 160, Phoenix, AZ 85016-3947 | 2018-07-25 |
| 1255826681 | Eric Bradford Vanausdal | Optometrist | 15215 S 48th St Ste 180, Phoenix, AZ 85044-9140 | 2018-06-27 |
| Find all providers in PHOENIX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.