Individual provider Active NPI

Tomas Diaz, RPH

  • Pharmacist
  • Bay Shore, NY
National Provider Identifier
1083937684
Registry record updated Mar 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
36707 Issued in NY
Practice address
1805 5TH Ave
Bay Shore, NY 11706-1761
Phone
(631) 231-4960
Fax
(631) 980-4279
NPI assigned
Mar 10, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 36707 NY Primary

Addresses

Primary practice location

1805 5TH Ave
Bay Shore, NY 11706-1761

Mailing address

1805 5TH Ave
Bay Shore, NY 11706-1761
Phone (631) 231-4960

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
36707NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
5TH Ave Drug, Inc Current Accepting new patients

Locations

1805 5th Ave
Bay Shore, NY 11706
Phone (631) 231-4960

Organizations & group practices 1

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": "1268179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268179200000",
    "number": "1083937684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 5TH AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117061761",
            "telephone_number": "631-231-4960",
            "fax_number": "631-980-4279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 5TH AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117061761",
            "telephone_number": "631-231-4960",
            "fax_number": "631-980-4279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "TOMAS",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-10",
        "last_updated": "2010-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "36707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.