Individual provider Active NPI

Juan C Zequeira Diaz, M.D.

  • Pediatric Emergency Medicine (Emergency Medicine) Physician
  • Bayamon, PR
National Provider Identifier
1154686236
Registry record updated Jan 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Emergency Medicine) PhysicianTaxonomy code 207PP0204X
License
21580 Issued in PR
Practice address
Carr #2, KM 11.7
Bayamon, PR 00959
Phone
(787) 474-8282
NPI assigned
Jul 5, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 279494 NY
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X 21580 PR Primary

Addresses

Primary practice location

Carr #2, KM 11.7
Bayamon, PR 00959

Mailing address

PO Box 426
Bayamon, PR 00960-0426
Phone (787) 474-8282

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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
I20260326003686 PR Practitioner - Emergency Medicine 4486959194 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Puerto Rico School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Recinto de Ciencias MedicasGroup PAC ID 3678469962, 246 clinicians

Practice addresses (Care Compare)

Carretera 3 KM
3 Avenida 65 Infanteria
Carolina, PR 00984
Phone (787) 757-6420

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
279494NYMDEmergency Medicine Physician
21580PRMDPediatric Emergency Medicine (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Medical Center Current Accepting new patients
Puerto Rico Women and Children S Hospital LLC PastSince Jan 31, 2021 Accepting new patients
Kingsbrook Medical Associates, PC Past Accepting new patients

Locations

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

Interoperability endpoints

  • Direct secure messaging: juanzequeiradiaz@mai.allscriptsdirect.net

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.

Hospital & facility affiliations 2

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": "1341446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611705600000",
    "number": "1154686236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 426",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009600426",
            "telephone_number": "787-474-8282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR #2, KM 11.7",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00959",
            "telephone_number": "787-474-8282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEQUEIRA DIAZ",
        "first_name": "JUAN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-05",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "279494",
            "primary": false
        },
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "PR",
            "license": "21580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

Verify at the official NPI Registry.