Individual provider Active NPI

Grisset Rivera Diaz, M.D.

  • Pediatrics Physician
  • Sugar Land, TX
National Provider Identifier
1235361999
Registry record updated Mar 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
P3965 Issued in TX
Practice address
15551 Southwest Fwy
Sugar Land, TX 77478-3830
Phone
(281) 325-1010
NPI assigned
Aug 13, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X P3965 TX Primary
Pediatrics Physician 208000000X ME113359 FL

Addresses

Primary practice location

15551 Southwest Fwy
Sugar Land, TX 77478-3830

Mailing address

15551 Southwest Fwy
Sugar Land, TX 77478-3830
Phone (281) 325-1010

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
I20230531003725 FL Practitioner - Pediatric Medicine 6204128085 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P3965TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health System/Sunbelt, Inc. Pediatrics CurrentSince May 29, 2023 Accepting new patients
Adventist Health System Sunbelt, Inc. Pediatrics Current Accepting new patients
Adventist Health System/ Sunbelt, Inc. Pediatrics CurrentSince May 29, 2023 Accepting new patients

Locations

440 W State Road 436
Altamonte Springs, FL 32714
Phone (407) 788-2000

2600 Westhall Ln
Ste 300
Maitland, FL 32751
Phone (407) 200-1353

Interoperability endpoints

  • Direct secure messaging: griveradiaz1530655@adventhealth.direct-ci.com

Organizations & group practices 3

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": "1250121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363824000000",
    "number": "1235361999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15551 SOUTHWEST FWY",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774783830",
            "telephone_number": "281-325-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15551 SOUTHWEST FWY",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774783830",
            "telephone_number": "281-325-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA DIAZ",
        "first_name": "GRISSET",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-13",
        "last_updated": "2013-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "P3965",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME113359",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

Verify at the official NPI Registry.