Henry Diaz, M.D.

Individual provider Active NPI Cardiovascular Disease Physician · Coamo, PR

NPI 1154376952 · NPPES record last updated Oct 30, 2023

Key facts

NPI
1154376952
Entity type
Individual (NPI type 1)
Primary specialty
Cardiovascular Disease Physician 207RC0000X
License
12894 (PR)
Practice address
Calle Mario Brachi Num 9
Coamo, PR 00769-0000
Phone
(787) 803-3636
Fax
(787) 825-4968
NPI assigned
May 23, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Medicare Care Compare profile

Specialty
Cardiovascular Disease (Cardiology)
Also: Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

111 Blvd Piel Canela
Coamo, PR 00769-3502
Phone (787) 803-3636

Hospital & facility affiliations

  • Hospital Episcopal San Lucas II Hospital · Ponce, PR · CCN 400044

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20110621000051 PR Practitioner - Cardiovascular Disease (Cardiology)
Practitioner - Internal Medicine
5597943639 Reassigns benefits to 3 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Med Centro, Inc. Current Accepting new patients
Med Centro, Inc. Current
since Dec 6, 2023
Accepting new patients
Med Centro, Inc. Current
since Dec 6, 2023
Accepting new patients
Intermed, LLC Past
since May 2, 2017
Accepting new patients

Locations

1034 Ave Hostos
Ponce, PR 00716
Phone (787) 242-2279

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 12894 PR Yes

Addresses

Primary practice location

Calle Mario Brachi Num 9
Coamo, PR 00769-0000

Mailing address

PO Box 2156
Coamo, PR 00769-2156
Phone (787) 841-0525

Other identifiers

IdentifierTypeStateIssuer
M000396OtherPRPLAN MENONITA
P00103108OtherPRPALMETTO
7690016OtherPRHUMANA INSURANCE
7690016OtherPRHUMANA REFORMA
061763OtherPRCRUZ AZUL DE PUERTO RICO
4512894OtherPRUIA
600865OtherPRMEDICARE Y MUCHO MAS
7690016OtherPRHUMANA HEALTH PLAN
20481OtherPRTRIPLE S
212645OtherPRPREFERRED HEALTH
7789OtherPRFIRST MEDICAL
38385OtherPRPROSSAM
PE4134OtherPRPALIC PROVIDER

Other providers in Coamo, PR

All providers in Coamo, PR · Cardiovascular Disease Physician in Puerto Rico

Sources for this page

Verify at the official NPI Registry.