Individual provider Active NPI

Alan Diaz, M.D.

  • Internal Medicine Physician
  • Bronx, NY
National Provider Identifier
1104936335
Registry record updated Jan 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
188017 Issued in NY
Practice address
2494 Williamsbridge Rd
Bronx, NY 10469-4806
Phone
(718) 652-1802
Fax
(718) 652-1889
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 188017 NY Primary

Addresses

Primary practice location

2494 Williamsbridge Rd
Bronx, NY 10469-4806

Mailing address

2494 Williamsbridge Rd
Bronx, NY 10469-4806
Phone (718) 652-1802

Other identifiers 1

IdentifierTypeStateIssuer
01725548MedicaidNY

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
I20041018000768 NY Practitioner - Internal Medicine 3072573633 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Icahn School of Medicine at Mount Sinai, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Salud Medical PCGroup PAC ID 9436107125, 2 clinicians

Practice addresses (Care Compare)

2494 Williamsbridge Rd
Bronx, NY 10469-4806
Phone (718) 652-1802

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Salud Medical PC Internal Medicine CurrentSince Jul 20, 2004 Accepting new patients
Montefiore North Ambulatory Care Center Inc Past Accepting new patients
Our Lady of Mercy Medical Center Past Accepting new patients
Our Lady of Mercy Ambulatory Care Center, Inc. Past Accepting new patients

Locations

2494 Williamsbridge Rd
Bronx, NY 10469
Phone (718) 652-1802

600 E 233rd St
Bronx, NY 10466
Phone (718) 920-1640

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GHHEAA/Endpoint/GHHEAA

Organizations & group practices 4

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262390400000",
    "number": "1104936335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2494 WILLIAMSBRIDGE RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104694806",
            "telephone_number": "718-652-1802",
            "fax_number": "718-652-1889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2494 WILLIAMSBRIDGE RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104694806",
            "telephone_number": "718-652-1802",
            "fax_number": "718-652-1889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2010-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "188017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01725548",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.