Individual provider Active NPI

Rolando Diaz Jr., M.D.

  • Emergency Medicine Physician
  • Odessa, TX
National Provider Identifier
1396807491
Registry record updated Nov 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
M5129 Issued in TX
Practice address
500 W 4TH St
Odessa, TX 79761-5001
Phone
(432) 640-1189
NPI assigned
Dec 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X M5129 TX Primary

Addresses

Primary practice location

500 W 4TH St
Odessa, TX 79761-5001

Mailing address

3112 Callaway Dr
Midland, TX 79707-5037
Phone (512) 800-4513

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20070725000323 TX Practitioner - Emergency Medicine 9830290535 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
85.33 of 100Reported as group
Quality
74.13
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M5129TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Concord Medical Group PLLC Emergency Medicine CurrentSince Aug 21, 2015 Accepting new patients
Concord Medical Group of Texas PLLC Emergency Medicine CurrentSince Aug 21, 2015 Accepting new patients
MCH Professional Care Hospital Based CurrentSince Aug 19, 2021 Accepting new patients
Basin Emergency Physicians PLLC Emergency Medicine CurrentSince Mar 11, 2009 Accepting new patients
Patriot Emergency Physicians PLLC Emergency Medicine Past Accepting new patients
Trans Pecos Emergency Physicians Emergency Medicine Past Accepting new patients

Locations

387 W Interstate 10
Fort Stockton, TX 79735
Phone (432) 336-2004

310 W South St
Henrietta, TX 76365
Phone (806) 647-2191

500 W 4th St
Odessa, TX 79761
Phone (432) 640-1000

305 N McKinney St
Sweeny, TX 77480
Phone (979) 548-1500

Organizations & group practices 6

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": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415059200000",
    "number": "1396807491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3112 CALLAWAY DR",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797075037",
            "telephone_number": "512-800-4513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W 4TH ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797615001",
            "telephone_number": "432-640-1189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "ROLANDO",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2014-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "M5129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

Verify at the official NPI Registry.