Individual provider Active NPI

Diya H Tantawi, MD, FACS

  • Plastic Surgery Physician
  • Rancho Mirage, CA
National Provider Identifier
1235372376
Registry record updated Apr 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
A126218 Issued in CA
Practice address
70225 Highway 111 Ste B&C
Rancho Mirage, CA 92270-2997
Phone
(760) 537-3023
Fax
(760) 837-8611
NPI assigned
Apr 18, 2009
Last updated
Apr 6, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X A126218 CA Primary
Surgery of the Hand (Surgery) Physician 2086S0105X A126218 CA
Plastic and Reconstructive Surgery Physician 2086S0122X A126218 CA

Addresses

Primary practice location

70225 Highway 111 Ste B&C
Rancho Mirage, CA 92270-2997

Mailing address

70225 Highway 111 Ste B&C
Rancho Mirage, CA 92270-2997
Phone (760) 537-3023

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, CA, TN3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20090604000248 WI Practitioner - General Surgery 4789734237 Reassigns benefits to 1 organization
I20181011000123 CA Practitioner - General SurgeryPractitioner - Plastic and Reconstructive Surgery 4789734237 Practice locations: Rancho Mirage, CA
I20181026000434 TN Practitioner - General Surgery 4789734237 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Plastic and Reconstructive Surgery
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

70225 Hwy 111
Suite Bandc
Rancho Mirage, CA 92270-2997
Phone (760) 537-3023

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Mastectomy15
Melanoma (skin cancer) excision11
Removal of tissue483

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A126218CAMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Memorial Medical Group Inc Surgery CurrentSince Aug 1, 2018 Accepting new patients
Mile Bluff Medical Center Inc CurrentSince Jul 15, 2017 Accepting new patients
Mile Bluff Medical Center Inc Current Accepting new patients
Baptist Memorial Medical Group Inc CurrentSince Aug 1, 2018 Accepting new patients
Mile Bluff Medical Center Inc Surgery CurrentSince Jul 15, 2017 Accepting new patients
Eisenhower Medical Center Past Accepting new patients

Locations

36 Capital Way
Ste E
Atoka, TN 38004
Phone (901) 837-6801

1040 Division St
Mauston, WI 53948
Phone (608) 847-5000

1050 Division St
Mauston, WI 53948
Phone (608) 847-6161

28 Commerce St
Wisconsin Dells, WI 53965
Phone (608) 254-5888

Organizations & group practices 6

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 2

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": "1240012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775433600000",
    "number": "1235372376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70225 HIGHWAY 111 STE B&C",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922702997",
            "telephone_number": "760-537-3023",
            "fax_number": "760-837-8611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70225 HIGHWAY 111 STE B&C",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922702997",
            "telephone_number": "760-537-3023",
            "fax_number": "760-837-8611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANTAWI",
        "first_name": "DIYA",
        "middle_name": "H",
        "credential": "MD, FACS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-18",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A126218",
            "primary": true
        },
        {
            "code": "2086S0105X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgery of the Hand",
            "state": "CA",
            "license": "A126218",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "A126218",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

Verify at the official NPI Registry.