Active NPI
Jose Diaz
- Ambulatory Care Registered Nurse
- San Lorenzo, PR
National Provider Identifier
1396191813
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Care Registered Nurse
- License
- 71810
- Practice address
- I10 Calle 6
Urb Tamarindo 1
San Lorenzo, PR 00754 - Phone
- (787) 340-5103
- NPI assigned
- May 13, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Care Registered Nurse | 163WP2201X | 71810 | PR | Primary |
| Health Service Clinic/Center | 261QH0100X | 71810 | PR | |
| Adolescent and Children Mental Health Clinic/Center | 261QM0855X | 71810 | PR |
Addresses
Primary practice location
I10 Calle 6
Urb Tamarindo 1
San Lorenzo, PR 00754
Mailing address
J-9 Calle Flamboyan
Urb Bosque Llano
San Lorenzo, PR 00754
Phone (787) 203-9985
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71810 | PR | MD | Adolescent and Children Mental Health Clinic/Center |
Practice roles
Organizations & group practices 2
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.
-
- Multi-Specialty Clinic/Center
- Gurabo, PR
- NPI 1790147262
Adolescent and Children Mental Health
-
- Multi-Specialty Clinic/Center
- Gurabo, PR
- NPI 1912551466
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463097600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463097600000",
"number": "1396191813",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "J-9 CALLE FLAMBOYAN",
"address_2": "URB BOSQUE LLANO",
"city": "SAN LORENZO",
"state": "PR",
"postal_code": "00754",
"telephone_number": "787-203-9985"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "I10 CALLE 6",
"address_2": "URB TAMARINDO 1",
"city": "SAN LORENZO",
"state": "PR",
"postal_code": "00754",
"telephone_number": "787-340-5103"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAZ",
"first_name": "JOSE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-05-13",
"last_updated": "2016-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "163WP2201X",
"taxonomy_group": "",
"desc": "Registered Nurse, Ambulatory Care",
"state": "PR",
"license": "71810",
"primary": true
},
{
"code": "261QH0100X",
"taxonomy_group": "",
"desc": "Clinic/Center, Health Service",
"state": "PR",
"license": "71810",
"primary": false
},
{
"code": "261QM0855X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adolescent and Children Mental Health",
"state": "PR",
"license": "71810",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Lorenzo, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.