Active NPI
Joaquin Diaz Jr., DPM
- Podiatrist
- Elmhurst, NY
National Provider Identifier
1467441998
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 0046421
- Practice address
- 87-08 Justice Ave
Suite CK
Elmhurst, NY 11373 - Phone
- (718) 899-0900
- Fax
- (718) 899-8118
- NPI assigned
- Oct 18, 2005
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 0046421 | NY | Primary |
Addresses
Primary practice location
87-08 Justice Ave
Suite CK
Elmhurst, NY 11373
Mailing address
87-08 Justice Ave
Suite CK
Elmhurst, NY 11373
Phone (718) 899-0900
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01668762 | Medicaid | NY | |
| 0020590 | Other | NY | GHI |
| P50801 | Other | NY | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0046421 | NY | MD | Podiatrist |
| 004642 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217894400000",
"number": "1467441998",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "87-08 JUSTICE AVE",
"address_2": "SUITE CK",
"city": "ELMHURST",
"state": "NY",
"postal_code": "11373",
"telephone_number": "718-899-0900",
"fax_number": "718-899-8118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "87-08 JUSTICE AVE",
"address_2": "SUITE CK",
"city": "ELMHURST",
"state": "NY",
"postal_code": "11373",
"telephone_number": "718-899-0900",
"fax_number": "718-899-8118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAZ",
"first_name": "JOAQUIN",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "DPM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-18",
"last_updated": "2008-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "NY",
"license": "0046421",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01668762",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI",
"identifier": "0020590",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "P50801",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Elmhurst, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.