Individual provider Active NPI

Denis Manuel Diaz, M.D.

  • Pediatrics Physician
  • Tavares, FL
National Provider Identifier
1215908371
Registry record updated Jun 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME118501 Issued in FL
Practice address
1765 David Walker Dr
Tavares, FL 32778-5745
Phone
(352) 343-3330
NPI assigned
Jan 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0101235887 VA
Pediatrics Physician 208000000X 2009-00227 NC
Pediatrics Physician 208000000X ME118501 FL Primary

Addresses

Primary practice location

1765 David Walker Dr
Tavares, FL 32778-5745

Mailing address

1765 David Walker Dr
Tavares, FL 32778-5745
Phone (352) 343-3330

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
I20140618001425 FL Practitioner - Pediatric Medicine 8921158635 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of South Florida College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cora Health Services IncGroup PAC ID 1759290992, shared by 21 NPIs, 1,125 clinicians

Practice addresses (Care Compare)

7015 Beracasa Way
Boca Raton, FL 33433-3453
Phone (561) 939-2033

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME118501FLMDPediatrics Physician
2009-00227NCMDPediatrics Physician
0101235887VAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc Pediatrics CurrentSince Jun 1, 2014 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Jun 1, 2014 Accepting new patients

Locations

1749 David Walker Dr
Tavares, FL 32778
Phone (352) 742-1760

1765 David Walker Dr
Tavares, FL 32778
Phone (352) 343-3330

Interoperability endpoints

  • Direct secure messaging: ddiaz57655@adventhealth.direct-ci.com

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401753600000",
    "number": "1215908371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1765 DAVID WALKER DR",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327785745",
            "telephone_number": "352-343-3330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1765 DAVID WALKER DR",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327785745",
            "telephone_number": "352-343-3330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "DENIS",
        "middle_name": "MANUEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2014-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101235887",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2009-00227",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME118501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tavares, FL

Sources for this page

Verify at the official NPI Registry.