Individual provider Active NPI

Eduardo Manuel Diaz Figueroa, M.D.

  • General Practice Physician
  • Ponce, PR
National Provider Identifier
1275868887
Registry record updated Jan 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
17708 Issued in PR
Practice address
2931 Ave Emilio Fagot Ste a
Ponce, PR 00716-3613
Phone
(787) 651-6673
Fax
(787) 651-6519
NPI assigned
Oct 15, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 17708 PR Primary

Addresses

Primary practice location

2931 Ave Emilio Fagot Ste a
Ponce, PR 00716-3613

Mailing address

PO Box 78
Mercedita, PR 00715
Phone (787) 651-6673

Other practice location 1

2905 Ave Emilio Fagot
Ponce, PR 00716-3613
Phone (787) 651-6673

Other identifiers 1

IdentifierTypeStateIssuer
DQ202AMedicaidPR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101018000607 PR Practitioner - General Practice 7416140983 Practice locations: Ponce, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2931 Ave Emilio Fagot
Ste. a
Ponce, PR 00716-3613
Phone (787) 651-6673

Hospital & facility affiliations

  • Hospicio la Paz Inc Hospice, Arecibo, PR, CCN 401527

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17708PRMDGeneral Practice Physician

Hospital & facility affiliations 1

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": "1255564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578873600000",
    "number": "1275868887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 78",
            "city": "MERCEDITA",
            "state": "PR",
            "postal_code": "00715",
            "telephone_number": "787-651-6673",
            "fax_number": "787-651-6519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2931 AVE EMILIO FAGOT STE A",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007163613",
            "telephone_number": "787-651-6673",
            "fax_number": "787-651-6519"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2905 Ave Emilio Fagot",
            "address_purpose": "LOCATION",
            "city": "Ponce",
            "state": "PR",
            "postal_code": "007163613",
            "country_code": "US",
            "telephone_number": "787-651-6673",
            "fax_number": "787-651-6519",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIAZ FIGUEROA",
        "first_name": "EDUARDO",
        "middle_name": "MANUEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-10-15",
        "last_updated": "2020-01-13",
        "certification_date": "2020-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "17708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DQ202A",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.