Individual provider Active NPI

Carol Rogers Diraimondo, MD

  • Nephrology Physician
  • Walnut Creek, CA
National Provider Identifier
1265433288
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
G49855 Issued in CA
Practice address
112 La Casa Via
Ste 210
Walnut Creek, CA 94598-3091
Phone
(925) 944-0351
Fax
(925) 944-1957
NPI assigned
Aug 2, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X G49855 CA Primary

Addresses

Primary practice location

112 La Casa Via
Ste 210
Walnut Creek, CA 94598-3091

Mailing address

112 La Casa Via
Ste 210
Walnut Creek, CA 94598-3091
Phone (925) 944-0351

Other identifiers 2

IdentifierTypeStateIssuer
CP2044OtherRAILROAD MEDICARE
GR0020610MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G49855CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Diablo Nephrology Medical Group, Inc Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11865/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265433288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 LA CASA VIA",
            "address_2": "STE 210",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983091",
            "telephone_number": "925-944-0351",
            "fax_number": "925-944-1957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 LA CASA VIA",
            "address_2": "STE 210",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983091",
            "telephone_number": "925-944-0351",
            "fax_number": "925-944-1957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIRAIMONDO",
        "first_name": "CAROL",
        "middle_name": "ROGERS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "G49855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CP2044",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0020610",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.