Individual provider Active NPI

Alwin A Diaz, N.P.

  • Nurse Practitioner
  • Kenosha, WI
National Provider Identifier
1245610658
Registry record updated Jan 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
6367-33 Issued in WI
Practice address
7201 Green Bay Rd
Kenosha, WI 53142-3532
Phone
(262) 432-2352
Fax
(262) 697-5616
NPI assigned
Jun 2, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 6367-33 WI Primary

Addresses

Primary practice location

7201 Green Bay Rd
Kenosha, WI 53142-3532

Mailing address

1675 N Barker Rd
Brookfield, WI 53045-5200
Phone (414) 755-4898

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20150617000572 WI Practitioner - Nurse Practitioner 8022329085 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Horizon Healthcare, IncGroup PAC ID 0749182160, 15 clinicians

Practice addresses (Care Compare)

4650 S Howell Ave
Milwaukee, WI 53207-5908
Phone (414) 376-5577

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Horizon Healthcare, Inc Nurse Practitioner CurrentSince Dec 1, 2020 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Dec 26, 2023 Accepting new patients
Horizon Healthcare, Inc. CurrentSince Dec 1, 2020 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Dec 26, 2023 Accepting new patients

Locations

3410 80th St
Kenosha, WI 53142
Phone (262) 697-0825

4650 S Howell Ave
Milwaukee, WI 53207
Phone (414) 294-0144

2819 W Highland Blvd
Milwaukee, WI 53208
Phone (414) 939-7145

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

5555 N 51st St
Milwaukee, WI 53218
Phone (414) 527-6940

5005 W Howard Ave
Milwaukee, WI 53220

2835 N 32nd St
Milwaukee, WI 53210
Phone (414) 342-6200

130 W Bruce St
Ste 300
Milwaukee, WI 53204
Phone (414) 384-1400

5408 W Burleigh St
Milwaukee, WI 53210
Phone (414) 445-6520

9555 76th St
Pleasant Prairie, WI 53158
Phone (262) 577-8000

835 Wisconsin Ave
Racine, WI 53403

741 N Grand Ave
Ste 200
Waukesha, WI 53186
Phone (262) 309-6243

Interoperability endpoints

  • Direct secure messaging: adiaz387658@direct.myadvocateaurora.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1433203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452124800000",
    "number": "1245610658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 N BARKER RD",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530455200",
            "telephone_number": "414-755-4898",
            "fax_number": "262-754-0067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7201 GREEN BAY RD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531423532",
            "telephone_number": "262-432-2352",
            "fax_number": "262-697-5616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "ALWIN",
        "middle_name": "A",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-02",
        "last_updated": "2016-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "6367-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

Verify at the official NPI Registry.