Individual provider Active NPI

Laura Diaz, PA-C

  • Physician Assistant
  • West Palm Beach, FL
National Provider Identifier
1306356704
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00451500 Issued in NJ
Practice address
2007 Palm Beach Lakes Blvd
West Palm Beach, FL 33409-6501
Phone
(561) 688-5808
NPI assigned
Oct 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00451500 NJ Primary

Addresses

Primary practice location

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

Mailing address

2007 Palm Beach Lakes Blvd
West Palm Beach, FL 33409-6501
Phone (561) 688-5808

Other practice location 1

7600 River Rd
North Bergen, NJ 07047-6217
Phone (201) 854-5100

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
I20191025002360 FL Practitioner - Physician Assistant 5597024711 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
Group practices
MD Now Medical Centers IncGroup PAC ID 3971554825, 314 clinicians

Practice addresses (Care Compare)

1770 NE Miami Gardens Dr
N Miami Beach, FL 33179-5301
Phone (305) 949-4141

4001 SW 72ND Ave
Miami, FL 33155-4556
Phone (305) 663-5770

4570 Lantana Rd
Lake Worth, FL 33463-6908
Phone (561) 963-9881

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25MP00451500NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
MD Now Medical Centers Inc CurrentSince Sep 27, 2019 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

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

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": "1507680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1306356704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2007 PALM BEACH LAKES BLVD",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334096501",
            "telephone_number": "561-688-5808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2007 PALM BEACH LAKES BLVD",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334096501",
            "telephone_number": "561-688-5808"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7600 River Rd",
            "address_purpose": "LOCATION",
            "city": "North Bergen",
            "state": "NJ",
            "postal_code": "070476217",
            "country_code": "US",
            "telephone_number": "201-854-5100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "LAURA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-11",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00451500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.