Individual provider Active NPI

Luis C Diaz, M.D.

  • Emergency Medicine Physician
  • Okeechobee, FL
National Provider Identifier
1083600092
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME88391 Issued in FL
Practice address
1796 N Hwy 441
Okeechobee, FL 34973
Phone
(863) 763-2151
Fax
(863) 763-2151
NPI assigned
Sep 26, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
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
Emergency Medicine Physician 207P00000X ME88391 FL Primary

Addresses

Primary practice location

1796 N Hwy 441
Okeechobee, FL 34973

Mailing address

214 NW Pleasant Grove Way
Port St Lucie, FL 34986-3584
Phone (772) 879-0018

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
I20040407001527 FL Practitioner - Family PracticePractitioner - Emergency Medicine 6709777089 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Contracting Services LLC Emergency Medicine CurrentSince Nov 1, 2013 Accepting new patients
Turtle Run Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Emcare Physician Providers, Inc. Emergency Medicine Past Accepting new patients
Pelican Coast Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Sailfish ER SVCS Partnership LLC Emergency Medicine Past Accepting new patients
Emcare Physician Providers, Inc. Emergency Medicine Past Accepting new patients
Okeechobee Emergency Physicians Inc Emergency Medicine Past Accepting new patients
Wuesthoff Emergency Physicians-Melbourne PA Emergency Medicine Past Accepting new patients
Alegent Creighton Clinic Past Accepting new patients
Emcare Physician Providers, Inc. Emergency Medicine Past Accepting new patients
Emcare Physician Providers, Inc. Emergency Medicine Past Accepting new patients
Alegent Health Immanuel Medical Center Past Accepting new patients

Locations

901 45th St
Mangonia Park, FL 33407
Phone (561) 844-6300

1095 NW Saint Lucie West Blvd
Port St Lucie, FL 34986
Phone (772) 785-5500

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083600092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 NW PLEASANT GROVE WAY",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349863584",
            "telephone_number": "772-879-0018",
            "fax_number": "772-879-0018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1796 N HWY 441",
            "city": "OKEECHOBEE",
            "state": "FL",
            "postal_code": "34973",
            "telephone_number": "863-763-2151",
            "fax_number": "863-763-2151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "LUIS",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME88391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Okeechobee, FL

Sources for this page

Verify at the official NPI Registry.