Individual provider Active NPI

Julian Diaz, LMSW

  • Clinical Social Worker
  • Troy, MI
National Provider Identifier
1447501648
Registry record updated Feb 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801094963 Issued in MI
Practice address
2075 W Big Beaver Rd
Troy, MI 48084-3407
Phone
(248) 646-6659
NPI assigned
Sep 27, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801094963 MI Primary

Addresses

Primary practice location

2075 W Big Beaver Rd
Troy, MI 48084-3407

Mailing address

8568 Eral CT
Ypsilanti, MI 48198-9557
Phone (810) 599-5082

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160418001395 MI Practitioner - Clinical Social Worker 7911205430 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Birmingham Maple ClinicGroup PAC ID 6800867755, 14 clinicians

Practice addresses (Care Compare)

2075 W Big Beaver Rd
Suite 520
Troy, MI 48084-3442
Phone (248) 646-6659

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801094963MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jeffrey a. London MD PC Past Accepting new patients

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1348704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423612800000",
    "number": "1447501648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8568 ERAL CT",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481989557",
            "telephone_number": "810-599-5082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2075 W BIG BEAVER RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480843407",
            "telephone_number": "248-646-6659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "JULIAN",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-27",
        "last_updated": "2015-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801094963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.