Individual provider Active NPI

Danny Raymond Diaz, PA-C, PT,DPT

  • Medical Physician Assistant
  • Palmetto Bay, FL
National Provider Identifier
1194117184
Registry record updated Jan 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
9111731 Issued in FL
Practice address
9333 SW 152ND St
Palmetto Bay, FL 33157-1778
Phone
(305) 251-2500
NPI assigned
Feb 27, 2015
Last updated
Jan 26, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9111731 FL
Physician Assistant 363A00000X
Physician Assistant 363A00000X 25MP00494400 NJ
Medical Physician Assistant 363AM0700X 9111731 FL Primary
Physical Therapist 225100000X 40QA01595600 NJ

Addresses

Primary practice location

9333 SW 152ND St
Palmetto Bay, FL 33157-1778

Mailing address

14051 SW 72ND Ter
Miami, FL 33183-3122
Phone (305) 469-3074

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220728000120 FL Practitioner - Physician Assistant 1153634480 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Intensive Care Consortium IncGroup PAC ID 0244269413, 485 clinicians

Practice addresses (Care Compare)

2201 45TH St
West Palm Beach, FL 33407-2047
Phone (561) 642-3094

5301 S Congress Ave
Atlantis, FL 33462-1149
Phone (561) 965-7300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
40QA01595600NJMDPhysical Therapist
25MP00494400NJMDPhysician Assistant
9111731FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sterling Emergency Services of Miami Beach PA Physician Assistant CurrentSince Jun 30, 2022 Accepting new patients

Locations

2845 NE 199th St
Miami, FL 33180
Phone (305) 692-1000

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": "1424995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1194117184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14051 SW 72ND TER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331833122",
            "telephone_number": "305-469-3074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9333 SW 152ND ST",
            "city": "PALMETTO BAY",
            "state": "FL",
            "postal_code": "331571778",
            "telephone_number": "305-251-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "DANNY",
        "middle_name": "RAYMOND",
        "credential": "PA-C, PT,DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-02-27",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9111731",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00494400",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "9111731",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01595600",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmetto Bay, FL

Sources for this page

Verify at the official NPI Registry.