Individual provider Active NPI

Fernando N Diaz, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Hollywood, FL
National Provider Identifier
1174699870
Registry record updated Dec 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
ME 0036602 Issued in FL
Practice address
3990 Sheridan St
Suite 206
Hollywood, FL 33021-3656
Phone
(954) 987-8183
Fax
(957) 987-4186
NPI assigned
Nov 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X ME 0036602 FL Primary

Addresses

Primary practice location

3990 Sheridan St
Suite 206
Hollywood, FL 33021-3656

Mailing address

3990 Sheridan St
Suite 206
Hollywood, FL 33021-3656
Phone (954) 987-8183

Other identifiers 1

IdentifierTypeStateIssuer
039555200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20120228000603 FL Practitioner - EndocrinologyPractitioner - Nuclear Medicine 5193983740 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Nuclear Medicine
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3990 Sheridan St
Suite 206
Hollywood, FL 33021-3656

3990 Sheridan St
Suite 206
Hollywood, FL 33021-6730
Phone (954) 987-8183

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 0036602FLMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fernando N Diaz, MD. PA Endocrinology, Diabetes & Metabolism CurrentSince Jul 1, 1980 Accepting new patients

Locations

3990 Sheridan St
Ste 206
Hollywood, FL 33021
Phone (954) 987-8183

3990 Sheridan St
Ste 20
Hollywood, FL 33021
Phone (954) 987-8183

Organizations & group practices 1

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 3

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": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419984000000",
    "number": "1174699870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3990 SHERIDAN ST",
            "address_2": "SUITE 206",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213656",
            "telephone_number": "954-987-8183",
            "fax_number": "957-987-4186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3990 SHERIDAN ST",
            "address_2": "SUITE 206",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213656",
            "telephone_number": "954-987-8183",
            "fax_number": "957-987-4186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "FERNANDO",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-27",
        "last_updated": "2014-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "FL",
            "license": "ME 0036602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "039555200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.