Individual provider Active NPI

Gilda Diaz-Fuentes, MD

  • Pulmonary Disease Physician
  • Bronx, NY
National Provider Identifier
1073553848
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
201175 Issued in NY
Practice address
1770 Grand Concourse
2G
Bronx, NY 10457-5524
Phone
(718) 518-5581
Fax
(718) 299-1877
NPI assigned
Jun 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 201175 NY Primary

Addresses

Primary practice location

1770 Grand Concourse
2G
Bronx, NY 10457-5524

Mailing address

PO Box 1786
Bronx, NY 10451-1786
Phone (718) 901-8154

Other identifiers 1

IdentifierTypeStateIssuer
01613950MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20090421000037 NY Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 3173529997 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Internal Medicine
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bronxcare Health SystemGroup PAC ID 3870404429, 335 clinicians

Practice addresses (Care Compare)

1650 Grand Concourse
Bronx, NY 10457-7606

199 Mount Eden Pkwy
Bronx, NY 10457-7703

199 Mount Eden Pkwy 3
Bronx Lebanon Ambulatory Care
Bronx, NY 10457-7703
Phone (718) 992-7669

199 Mount Eden Pkwy 3Rd
Bronx Lebanon Ambulatory Care
Bronx, NY 10457-7703
Phone (718) 992-7669

199 Mount Eden Pkwy Floor
3 Bronx Lebanon Healthandwellness Center
Bronx, NY 10457-7703
Phone (718) 992-7669

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bronxcare Health System CurrentSince Oct 1, 2008 Accepting new patients
Bronxcare Health System CurrentSince Oct 1, 2008 Accepting new patients
Bronxcare Health System Past Accepting new patients
Bronxcare Health System Past Accepting new patients
Ernst, Sy and Menon Past Accepting new patients

Locations

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

1276 Fulton Ave
#208
Bronx, NY 10456
Phone (718) 901-8911

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: gildadiazfuentes@blhc.allscriptsdirect.net

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073553848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1786",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104511786",
            "telephone_number": "718-901-8154",
            "fax_number": "718-901-8151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 GRAND CONCOURSE",
            "address_2": "2G",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104575524",
            "telephone_number": "718-518-5581",
            "fax_number": "718-299-1877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ-FUENTES",
        "first_name": "GILDA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "201175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01613950",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.