NPIMap

Individual provider Active NPI

Sarah Elizabeth Diaz de Leon, M.D.

  • Family Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1275854093
Registry record updated Dec 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
P4042 Issued in TX
Practice address
1500 S Main St FL 4
Fort Worth, TX 76104-4917
Phone
(817) 702-1215
Fax
(817) 702-6843
NPI assigned
Jun 16, 2010
Last updated
Dec 13, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X BP10037206 TX
Family Medicine Physician 207Q00000X P4042 TX Primary

Addresses

Primary practice location

1500 S Main St FL 4
Fort Worth, TX 76104-4917

Mailing address

PO Box 732973
Dallas, TX 75373-2973
Phone (817) 702-8450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20130828000699 TX Practitioner - Family Practice 0941443667 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Health Center LLPGroup PAC ID 3476522012, 8 clinicians

Practice addresses (Care Compare)

2768 Pharmacy Rd
Rio Grande City, TX 78582-6201
Phone (956) 487-5621

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P4042TXMDFamily Medicine Physician
BP10037206TXMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
FHC RGC, PA CurrentSince Sep 23, 2024 Accepting new patients
Family Health Center LLP Family Medicine CurrentSince Jan 1, 2015 Accepting new patients
Acclaim Physician Group, Inc CurrentSince May 1, 2016 Accepting new patients

Locations

1350 S Main St
Fl 1
Fort Worth, TX 76104
Phone (817) 702-3701

1500 S Main St
Fl 4
Fort Worth, TX 76104
Phone (817) 702-1215

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

2768 Pharmacy Rd
Rio Grande Cy, TX 78582
Phone (956) 487-5621

Interoperability endpoints

  • Direct secure messaging: sarah.diaz.de.leon.1@32458.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Family Health Center LLPRio Grande City, TX, CCN 453812 Rural health clinic 5% Or Greater Direct Ownership Interest (35%) Apr 7, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

Hospital & facility affiliations 7

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": "1276646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544659200000",
    "number": "1275854093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 732973",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753732973",
            "telephone_number": "817-702-8450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S MAIN ST FL 4",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044917",
            "telephone_number": "817-702-1215",
            "fax_number": "817-702-6843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ DE LEON",
        "first_name": "SARAH",
        "middle_name": "ELIZABETH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-16",
        "last_updated": "2018-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "BP10037206",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "P4042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.