NPIMap

Individual provider Active NPI

Edwin A Diaz, M.D.

  • Urology Physician
  • North Little Rock, AR
National Provider Identifier
1275508939
Registry record updated Dec 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
E4076 Issued in AR
Practice address
3401 Springhill Dr
Suite345
North Little Rock, AR 72117-2924
Phone
(501) 945-2121
Fax
(501) 537-1875
NPI assigned
Feb 17, 2006
Last updated
Dec 5, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X E4076 AR Primary

Addresses

Primary practice location

3401 Springhill Dr
Suite345
North Little Rock, AR 72117-2924

Mailing address

3401 Springhill Dr
Suite345
North Little Rock, AR 72117-2924
Phone (501) 945-2121

Other identifiers 2

IdentifierTypeStateIssuer
P00137126OtherARRAILROAD MEDICARE
154196001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040629000101 AR Practitioner - Urology 8527044692 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Arkansas Urology, P.a.Group PAC ID 4082502547, 39 clinicians

Practice addresses (Care Compare)

1300 Centerview Dr
Little Rock, AR 72211-4349
Phone (501) 219-8900

1375 Superior Dr
Conway, AR 72032-7018
Phone (501) 219-8900

2504 W Main St
Suite a
Russellville, AR 72801-2536
Phone (501) 219-8900

4200 Stockton Dr
North Little Rock, AR 72117-2915
Phone (501) 410-1188

4800 E Johnson Ave
Jonesboro, AR 72405-8413
Phone (870) 936-0140

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E4076ARMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Urology, P.a. Urology CurrentSince Aug 2, 2004 Accepting new patients
Northeast Arkansas Clinic Charitable Foundation, Inc. CurrentSince Apr 22, 2025 Accepting new patients
Northeast Arkansas Clinic Charitable Foundation, Inc. Current Accepting new patients
Northeast Arkansas Clinic Charitable Foundation, Inc. Current Accepting new patients

Locations

1111 Windover Rd
Jonesboro, AR 72401
Phone (870) 935-5432

4800 E Johnson Ave
Jonesboro, AR 72405
Phone (870) 732-2100

1300 Centerview Dr
Little Rock, AR 72211
Phone (501) 410-1196

3401 Springhill Dr
Ste 345
North Little Rock, AR 72117
Phone (501) 907-7300

4200 Stockton Dr
North Little Rock, AR 72117
Phone (501) 945-2121

2504 W Main St
Ste A
Russellville, AR 72801
Phone (479) 964-3278

Interoperability endpoints

  • Direct secure messaging: edwin.diaz.1@10448.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/10448/brand/1/csg/1/fhir/r4

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.

Hospital & facility affiliations 6

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": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196812800000",
    "number": "1275508939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 SPRINGHILL DR",
            "address_2": "SUITE345",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721172924",
            "telephone_number": "501-945-2121",
            "fax_number": "501-537-1875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 SPRINGHILL DR",
            "address_2": "SUITE345",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721172924",
            "telephone_number": "501-945-2121",
            "fax_number": "501-537-1875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "EDWIN",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2007-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "AR",
            "license": "E4076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00137126",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154196001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Little Rock, AR

Sources for this page

Verify at the official NPI Registry.