Individual provider Active NPI

Giovanni Alexis Ortiz Diaz, MD

  • General Practice Physician
  • San Juan, PR
National Provider Identifier
1235655358
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
23000 Issued in PR
Practice address
33 F2 Calle Higuero
Laderas de San Juan
San Juan, PR 00926
Phone
(787) 307-2727
NPI assigned
Aug 21, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 23000 PR Primary

Addresses

Primary practice location

33 F2 Calle Higuero
Laderas de San Juan
San Juan, PR 00926

Mailing address

33 Calle Higuero
Laderas de San Juan
San Juan, PR 00926
Phone (787) 307-2727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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
I20230320003066 PR Practitioner - General Practice 3779957469 Reassigns benefits to 1 organization
Practice locations: Vega Alta, PR

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Physician H.M.O. Inc. CurrentSince Aug 1, 2023 Accepting new patients
Gaod Enterprises LLC General Practice CurrentSince Sep 1, 2022 Accepting new patients

Locations

107 Calle Padre Las Casas
San Juan, PR 00918
Phone (787) 294-7801

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": "1503273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1235655358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 CALLE HIGUERO",
            "address_2": "LADERAS DE SAN JUAN",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00926",
            "telephone_number": "787-307-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 F2 CALLE HIGUERO",
            "address_2": "LADERAS DE SAN JUAN",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00926",
            "telephone_number": "787-307-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ DIAZ",
        "first_name": "GIOVANNI",
        "middle_name": "ALEXIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-21",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "23000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.