NPIMap

Individual provider Active NPI

Carlos Javier Diaz Velez, MD

  • Internal Medicine Physician
  • Shavano Park, TX
National Provider Identifier
1316061377
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
N0732 Issued in TX
Practice address
4085 De Zavala Rd Ste 200
Shavano Park, TX 78249-2084
Phone
(210) 558-6288
Fax
(210) 558-6289
NPI assigned
Mar 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X N0732 TX Primary

Addresses

Primary practice location

4085 De Zavala Rd Ste 200
Shavano Park, TX 78249-2084

Mailing address

PO Box 781616
San Antonio, TX 78278-1616
Phone (210) 558-6288

Other identifiers 3

IdentifierTypeStateIssuer
196858803MedicaidTX
196858801MedicaidTX
196858802MedicaidTX

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
I20081107000683 TX Practitioner - Internal Medicine 1951460740 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

109 Ashling
San Antonio, TX 78260-3507
Phone (915) 471-8975

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N0732TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Diaz Hospitalist Group PLLC Internal Medicine CurrentSince Mar 1, 2013 Accepting new patients
Physicians and Allied Health Professionals Group, PA Internal Medicine Past Accepting new patients
Methodist Healthcare System of San Antonio, LTD., L.L.P. Past Accepting new patients
GMG Health Systems Associates PA Internal Medicine PastSince Dec 27, 2009 Accepting new patients
El Paso Hospitalist Group PLLC Internal Medicine Past Accepting new patients

Locations

4085 De Zavala Rd
Ste 200
Shavano Park, TX 78249
Phone 2105586288123

Organizations & group practices 5

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.

Hospital & facility affiliations 3

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": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1316061377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781616",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782781616",
            "telephone_number": "210-558-6288",
            "fax_number": "210-558-6289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4085 DE ZAVALA RD STE 200",
            "city": "SHAVANO PARK",
            "state": "TX",
            "postal_code": "782492084",
            "telephone_number": "210-558-6288",
            "fax_number": "210-558-6289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ VELEZ",
        "first_name": "CARLOS",
        "middle_name": "JAVIER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "N0732",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "196858803",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "196858801",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "196858802",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shavano Park, TX

Sources for this page

Verify at the official NPI Registry.