Individual provider Active NPI

Jasmin Nataly Diaz, PA

  • Physician Assistant
  • Tucson, AZ
National Provider Identifier
1093426009
Registry record updated Nov 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9967 Issued in AZ
Practice address
1714 W Anklam Rd Ste 104
Tucson, AZ 85745-2661
Phone
(520) 838-3540
Fax
(520) 325-3526
NPI assigned
Dec 9, 2022
Last updated
Nov 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X AZ
Physician Assistant 363A00000X 9967 AZ Primary

Addresses

Primary practice location

1714 W Anklam Rd Ste 104
Tucson, AZ 85745-2661

Mailing address

555 E River Rd Ste 101
Tucson, AZ 85704-5843
Phone (520) 838-3540

Other practice location 1

435 N 5th St
Phoenix, AZ 85004-2157
Phone (520) 220-0506

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231219003070 AZ Practitioner - Physician Assistant 6406206382 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4582 N 1St Ave
Suite 170
Tucson, AZ 85718-8607
Phone (520) 318-6035

4881 E Grant Rd
Tucson, AZ 85712-2704
Phone (520) 829-6776

Merit-based Incentive Payment System (MIPS)

Final score
45.68 of 100Reported as group
Quality
40.49
Promoting interoperability
0
Improvement activities
30
Cost
74.27

Merit-based Incentive Payment System (MIPS)

Final score
90.17 of 100Reported as group
Quality
83.77
Promoting interoperability
97
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9967AZMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Pain Institute of Southern Arizona Pisa PC CurrentSince Aug 22, 2024 Accepting new patients
Pain Institute of Southern Arizona Pisa PC CurrentSince Aug 22, 2024 Accepting new patients

Locations

4582 N 1st Ave
Ste 170
Tucson, AZ 85718
Phone (520) 505-3766

4881 E Grant Rd
Ste 101
Tucson, AZ 85712
Phone (520) 829-6776

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.72783

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, 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": "1670544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699920000000",
    "number": "1093426009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 E RIVER RD STE 101",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857045843",
            "telephone_number": "520-838-3540",
            "fax_number": "520-325-3526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1714 W ANKLAM RD STE 104",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857452661",
            "telephone_number": "520-838-3540",
            "fax_number": "520-325-3526"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "435 N 5th St",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850042157",
            "country_code": "US",
            "telephone_number": "520-220-0506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "JASMIN",
        "middle_name": "NATALY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-09",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AZ",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "9967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.