Individual provider Active NPI

Diego Jose Covarrubias, MD

  • Neuroradiology Physician
  • Grand Rapids, MI
National Provider Identifier
1366493678
Registry record updated May 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuroradiology PhysicianTaxonomy code 2085N0700X
License
326693 Issued in NY
Practice address
3264 N Evergreen Dr NE
Grand Rapids, MI 49525-9746
Phone
(616) 363-7272
Fax
(616) 361-5828
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2026

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X 61382258 WA
Neuroradiology Physician 2085N0700X 0101287214 VA
Diagnostic Radiology Physician 2085R0202X 4301504400 MI
Neuroradiology Physician 2085N0700X 326693 NY Primary
Diagnostic Radiology Physician 2085R0202X 24839 OR
Neuroradiology Physician 2085N0700X 4301504400 MI

Addresses

Primary practice location

3264 N Evergreen Dr NE
Grand Rapids, MI 49525-9746

Mailing address

3264 N Evergreen Dr NE
Grand Rapids, MI 49525-9746
Phone (616) 363-7272

Other identifiers 2

IdentifierTypeStateIssuer
29091MedicaidOR
029091MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240116002792 WA Practitioner - Diagnostic Radiology 2860487899 Reassigns benefits to 3 organizations
I20240205002607 NY Practitioner - Diagnostic Radiology 2860487899 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Irvine California College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians
Medical Center Radiologists IncGroup PAC ID 5395640650, 124 clinicians

Practice addresses (Care Compare)

White Salmon, WA 98672
Phone (516) 405-7099

100 E 77TH St
New York, NY 10075-1850

10201 66TH Rd
Forest Hills, NY 11375-2029
Phone (718) 830-4000

111 E 77TH St
New York, NY 10075-1850
Phone (212) 434-3966

1333 Heroes Way
Riverhead, NY 11901-2029
Phone (631) 727-2755

1333 Roanoke Ave
Riverhead, NY 11901-2029
Phone (631) 727-2755

1335 California Ave SW
Seattle, WA 98116-1606
Phone (516) 405-7000

1421 3Rd Ave
New York, NY 10028-1899
Phone (212) 744-5538

27005 75TH Ave
New Hyde Park, NY 11040-1402

27005 76TH Ave GF
New Hyde Park, NY 11040-1402
Phone (718) 470-7501

300 Community Dr
Manhasset, NY 11030-3816

300 Community Dr LL
Manhasset, NY 11030-3816
Phone (516) 562-2229

330 Community Dr
Manhasset, NY 11030-3816
Phone (516) 708-2550

350 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-3845

400 E Main St
Mount Kisco, NY 10549-3417
Phone (914) 666-1371

496 County Rd
111 BLDG F1
Manorville, NY 11949-3388
Phone (631) 405-3240

496 County Rd 111
Manorville, NY 11949-3386
Phone (631) 405-3220

811 Panorama CT
White Salmon, WA 98672-2175
Phone (757) 466-0089

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
90.33 of 100Reported as group
Quality
91.31
Improvement activities
40
Cost
79.05

Merit-based Incentive Payment System (MIPS)

Final score
95.17 of 100Reported as group
Quality
91.34
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301504400MIMDNeuroradiology Physician
326693NYMDNeuroradiology Physician
0101287214VAMDNeuroradiology Physician
61382258WAMDNeuroradiology Physician
24839ORMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Center Radiologists Inc Diagnostic Radiology CurrentSince Nov 1, 2025 Accepting new patients
Southside Faculty Medical Affiliates University Faculty Practice Corp CurrentSince Feb 1, 2024 Accepting new patients
North Shore-Lij Medical PC CurrentSince Feb 1, 2024 Accepting new patients
Salem Health West Valley PastSince Mar 3, 2011 Accepting new patients
Salem Imaging LLC Diagnostic Radiology Past Accepting new patients
Salem Radiology Consultants PC Diagnostic Radiology Past Accepting new patients
Tanasbourne Radiology Past Accepting new patients

Locations

670 Stoneleigh Ave
Carmel, NY 10512
Phone (845) 230-4721

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

1421 3rd Ave
New York, NY 10028
Phone (212) 744-5538

300 Community Dr
Plandome, NY 11030

9525 Queens Blvd
Frnt 2
Rego Park, NY 11374
Phone (718) 360-5522

1220 Hicksville Rd
Seaford, NY 11783

600 Gresham Dr
Ste 700
Norfolk, VA 23507
Phone (757) 388-1700

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: dcovarrubias68508@northwell.direct-ci.com
  • Direct secure messaging: dcovarrubias1123948@direct.hfhs.org
  • Direct secure messaging: dcovarrubias143283@direct.covenanthealthcare.com

Organizations & group practices 7

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 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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778112000000",
    "number": "1366493678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3264 N EVERGREEN DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259746",
            "telephone_number": "616-363-7272",
            "fax_number": "616-361-5828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3264 N EVERGREEN DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259746",
            "telephone_number": "616-363-7272",
            "fax_number": "616-361-5828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COVARRUBIAS",
        "first_name": "DIEGO",
        "middle_name": "JOSE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2026-05-07",
        "certification_date": "2026-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "WA",
            "license": "61382258",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "VA",
            "license": "0101287214",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301504400",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "NY",
            "license": "326693",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OR",
            "license": "24839",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "MI",
            "license": "4301504400",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "29091",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029091",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.