Individual provider Active NPI

Joaquin Diaz Jr., DPM

  • Podiatrist
  • Elmhurst, NY
National Provider Identifier
1467441998
Registry record updated Aug 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
0046421 Issued in NY
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

Updated by the provider on Aug 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
01668762MedicaidNY
0020590OtherNYGHI
P50801OtherNYBCBS

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
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0046421NYMDPodiatrist
004642NYMDPhysician 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

Verify at the official NPI Registry.