Individual provider Active NPI

Lucia Zoraida Diaz, M.D.

  • Pediatric Dermatology Physician
  • Austin, TX
National Provider Identifier
1043454515
Registry record updated Mar 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Dermatology PhysicianTaxonomy code 207NP0225X
License
P5172 Issued in TX
Practice address
1301 Barbara Jordan Blvd Ste 200
Austin, TX 78723-3078
Phone
(512) 628-1920
Fax
(512) 628-1921
NPI assigned
Apr 28, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dermatology Physician 207NP0225X P5172 TX Primary
Pediatric Dermatology Physician 207NP0225X A123654 CA

Addresses

Primary practice location

1301 Barbara Jordan Blvd Ste 200
Austin, TX 78723-3078

Mailing address

1301 Barbara Jordan Blvd Ste 200
Austin, TX 78723-3078
Phone (512) 628-1920

Other identifiers 2

IdentifierTypeStateIssuer
340229902MedicaidTX
340229901MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141021000562 TX Practitioner - Dermatology 5991926719 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Texas Medical School at San Antonio, 2009
Medicare assignment
May accept Medicare assignment
Group practices
Central Texas Community Health CentersGroup PAC ID 5395802151, shared by 33 NPIs, 165 clinicians

Practice addresses (Care Compare)

2901 Montopolis Dr
Austin, TX 78741-6411
Phone (512) 978-9955

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A123654CAMDPediatric Dermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dell Children'S Medical Group CurrentSince Oct 1, 2014 Accepting new patients
Dell Children'S Medical Group CurrentSince Oct 1, 2014 Accepting new patients

Locations

1301 Barbara Jordan Blvd
Ste 200
Austin, TX 78723
Phone (512) 628-1800

1000 Hesters Crossing Rd
Round Rock, TX 78681
Phone (512) 628-1800

Interoperability endpoints

  • Direct secure messaging: lucia.diaz.1@8363.direct.athenahealth.com

Organizations & group practices 2

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": "1240876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490572800000",
    "number": "1043454515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 BARBARA JORDAN BLVD STE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233078",
            "telephone_number": "512-628-1920",
            "fax_number": "512-628-1921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 BARBARA JORDAN BLVD STE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233078",
            "telephone_number": "512-628-1920",
            "fax_number": "512-628-1921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "LUCIA",
        "middle_name": "ZORAIDA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-28",
        "last_updated": "2017-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "TX",
            "license": "P5172",
            "primary": true
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "CA",
            "license": "A123654",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340229902",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340229901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.