Individual provider Active NPI

Jesus Diaz Vera

  • Infectious Disease Physician
  • Largo, FL
National Provider Identifier
1083177851
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
ME168436 Issued in FL
Practice address
1258 W Bay Dr Ste D
Largo, FL 33770-2277
Phone
(727) 420-6374
NPI assigned
Apr 9, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X ME168436 FL Primary

Addresses

Primary practice location

1258 W Bay Dr Ste D
Largo, FL 33770-2277

Mailing address

10460 Roosevelt Blvd N # 169
Saint Petersburg, FL 33716-3821
Phone (727) 420-6374

Other names 1

  • Jesus Diaz Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240524002270 FL Practitioner - Infectious Disease 3971945700 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
University of South Florida College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Id Team PAGroup PAC ID 8628318599, 5 clinicians
Premier Infectious Disease, LLCGroup PAC ID 8022583483, 7 clinicians

Practice addresses (Care Compare)

1258 W Bay Dr
Suite D
Largo, FL 33770-2277
Phone (727) 420-6374

1285 Creekside Blvd E
Unit 300
Naples, FL 34109-0598
Phone (239) 537-5909

Hospital & facility affiliations

  • HCA Florida Largo Hospital Hospital, Largo, FL, CCN 100248
  • St Anthonys Hospital Hospital, Saint Petersburg, FL, CCN 100067
  • HCA Florida St Petersburg Hospital Hospital, Saint Petersburg, FL, CCN 100180
  • St Josephs Hospital Hospital, Tampa, FL, CCN 100075
  • Physicians Regional Medical Center - Pine Ridge Hospital, Naples, FL, CCN 100286

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME168436FLMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Id Team PA Infectious Disease CurrentSince Jul 1, 2024 Accepting new patients

Locations

201 14th St SW
Largo, FL 33770
Phone (727) 588-5222

1258 West Bay Dr
Ste D
Largo, FL 33770
Phone (727) 420-6374

10460 Roosevelt Blvd N
St Petersburg, FL 33716
Phone (727) 259-9523

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: jesus.diazvera@390434541404164.direct.elationemr.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.

Hospital & facility affiliations 7

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": "1554768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1083177851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10460 ROOSEVELT BLVD N # 169",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337163821",
            "telephone_number": "727-420-6374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1258 W BAY DR STE D",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337702277",
            "telephone_number": "727-420-6374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ VERA",
        "first_name": "JESUS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-09",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "FL",
            "license": "ME168436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESUS",
            "last_name": "DIAZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Largo, FL

Sources for this page

Verify at the official NPI Registry.