Individual provider Active NPI

Gabriel Diaz, ARNP-BC

  • Gerontology Nurse Practitioner
  • Washington, DC
National Provider Identifier
1124492798
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
NP500003630 Issued in DC
Practice address
2150 Pennsylvania Ave NW
Washington, DC 20037-3201
Phone
(202) 741-2160
Fax
(202) 741-2169
NPI assigned
Nov 19, 2015
Last updated
Jul 20, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X ARNP 9323295 FL
Gerontology Nurse Practitioner 363LG0600X NP500003630 DC Primary

Addresses

Primary practice location

2150 Pennsylvania Ave NW
Washington, DC 20037-3201

Mailing address

4400 W Spruce St
Apt 243
Tampa, FL 33607-4149
Phone (813) 598-1438

Other practice location 1

2919 W Swann Ave
Suite 106
Tampa, FL 33609-4038
Phone (813) 930-2829

Other identifiers 2

IdentifierTypeStateIssuer
P3Y45OtherBCBS ID
016403100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160302001666 FL Practitioner - Nurse Practitioner 0143526053 Reassigns benefits to 1 organization
I20220802003974 DC Practitioner - Nurse Practitioner 0143526053 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Faculty Associates, IncGroup PAC ID 4082528898, 676 clinicians

Practice addresses (Care Compare)

2150 Pennsylvania Ave NW
Washington, DC 20037-3201
Phone (202) 741-2600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP 9323295FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Faculty Associates, Inc CurrentSince Jul 20, 2022 Accepting new patients
Florida Anesthesia Medical Services 1, PA CurrentSince Nov 28, 2018 Accepting new patients

Locations

2150 Pennsylvania Ave NW
Washington, DC 20037
Phone (202) 741-2222

900 23rd St NW
Washington, DC 20037
Phone (202) 715-4750

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-0793

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.

Hospital & facility affiliations 1

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": "1447891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1124492798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 W SPRUCE ST",
            "address_2": "APT 243",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336074149",
            "telephone_number": "813-598-1438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 PENNSYLVANIA AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200373201",
            "telephone_number": "202-741-2160",
            "fax_number": "202-741-2169"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2919 W Swann Ave",
            "address_2": "Suite 106",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336094038",
            "country_code": "US",
            "telephone_number": "813-930-2829",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "GABRIEL",
        "name_prefix": "Mr.",
        "credential": "ARNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-11-19",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP 9323295",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "DC",
            "license": "NP500003630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ID",
            "identifier": "P3Y45",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016403100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.