Individual provider Active NPI

Louis Diamond, PA

  • Physician Assistant
  • Bergenfield, NJ
National Provider Identifier
1265946222
Registry record updated Jul 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9113658 Issued in FL
Practice address
19 S Washington Ave
Bergenfield, NJ 07621-2324
Phone
(201) 387-0177
NPI assigned
Nov 28, 2017
Last updated
Jul 27, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00456500 NJ
Physician Assistant 363A00000X PA9113658 FL Primary

Addresses

Primary practice location

19 S Washington Ave
Bergenfield, NJ 07621-2324

Mailing address

10912 La Salinas Cir
Boca Raton, FL 33428-1237
Phone (561) 239-3436

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210211002907 FL Practitioner - Physician Assistant 3678807906 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

19 S Washington Ave
Bergenfield, NJ 07621-2324

2007 Palm Beach Lakes Blvd
West Palm Beach, FL 33409-6501

5080 Spectrum Dr
Suite 1200W
Addison, TX 75001-6443

6855 S Red Rd
Suite 600
South Miami, FL 33143

Merit-based Incentive Payment System (MIPS)

Final score
74.32 of 100Reported as group
Quality
41.6
Promoting interoperability
95
Improvement activities
40
Cost
76.98

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9113658FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
MD Now Medical Centers Inc CurrentSince Feb 8, 2021 Accepting new patients
Am PM Primary Care Past Accepting new patients

Locations

4570 Lantana Rd
Lake Worth, FL 33463
Phone (305) 949-4141

1770 NE Miami Gardens Dr
North Miami Beach, FL 33179
Phone (305) 949-4141

2007 Palm Beach Lakes Blvd
West Palm Beach, FL 33409

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, 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": "1511827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627344000000",
    "number": "1265946222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10912 LA SALINAS CIR",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334281237",
            "telephone_number": "561-239-3436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 S WASHINGTON AVE",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076212324",
            "telephone_number": "201-387-0177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAMOND",
        "first_name": "LOUIS",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-11-28",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00456500",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9113658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bergenfield, NJ

Sources for this page

Verify at the official NPI Registry.