Active NPI
Diego Puentez
- Skilled Nursing Facility
- Hammond, IN
National Provider Identifier
1194101790
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 057.000381
- Practice address
- 1117 Summer St
Hammond, IN 46320-2141 - Phone
- (219) 712-3043
- NPI assigned
- Aug 5, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | 057.000381 | IL | |
| Skilled Nursing Facility | 314000000X | 057.000381 | IL | Primary |
Addresses
Primary practice location
1117 Summer St
Hammond, IN 46320-2141
Mailing address
1117 Summer St
Hammond, IN 46320-2141
Other names 1
- Diego Puentez
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 057.000381 | IL | MD | Skilled Nursing Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438732800000",
"number": "1194101790",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1117 SUMMER ST",
"city": "HAMMOND",
"state": "IN",
"postal_code": "463202141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1117 SUMMER ST",
"city": "HAMMOND",
"state": "IN",
"postal_code": "463202141",
"telephone_number": "219-712-3043"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUENTEZ",
"first_name": "DIEGO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-08-05",
"last_updated": "2015-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "IL",
"license": "057.000381",
"primary": false
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "IL",
"license": "057.000381",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "DIEGO",
"last_name": "PUENTEZ",
"credential": "C.O.T.A.",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Hammond, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.