NPIMap

Individual provider Active NPI

Tanya I Diaz, MD

  • Family Medicine Physician
  • Leesburg, FL
National Provider Identifier
1467445080
Registry record updated Oct 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME90760 Issued in FL
Practice address
511 Medical Plaza Dr
Suite 101
Leesburg, FL 34748-7326
Phone
(352) 728-6808
Fax
(352) 728-1743
NPI assigned
Aug 30, 2005
Last updated
Oct 27, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME90760 FL Primary

Addresses

Primary practice location

511 Medical Plaza Dr
Suite 101
Leesburg, FL 34748-7326

Mailing address

511 Medical Plaza Dr
Suite 101
Leesburg, FL 34748-7326
Phone (352) 728-6808

Other identifiers 2

IdentifierTypeStateIssuer
270240100MedicaidFL
48179OtherFLBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050105000408 FL Practitioner - Family Practice 1759339922 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Puerto Rico School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cora Health Services IncGroup PAC ID 1759290992, shared by 21 NPIs, 1,125 clinicians
Orlando Physicians Network IncGroup PAC ID 7719026251, 231 clinicians

Practice addresses (Care Compare)

1050 Old Camp Rd
Suite 282
The Villages, FL 32162-1762
Phone (352) 693-3378

21 Columbia St
Orlando, FL 32806-1133
Phone (321) 841-6600

2953 Traverse TRL
The Villages, FL 32163-2017
Phone (352) 693-3378

8768 SE 165TH Mulberry LN
Cora Physical Therapy Mulberry Lane
The Villages, FL 32162-5861
Phone (352) 329-5237

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health, Inc. Current Accepting new patients
Orlando Physicians Network Inc Family Medicine CurrentSince Jan 1, 2021 Accepting new patients
Orlando Health Medical Group Inc Past Accepting new patients

Locations

511 Medical Plaza Dr
Ste 101
Leesburg, FL 34748

21 Columbia St
Orlando, FL 32806
Phone (321) 841-5560

8485 SE 165th Mulberry Ln
The Villages, FL 32162
Phone (352) 323-9545

Interoperability endpoints

  • Direct secure messaging: tdiaz346790@orlandohealth.medalliesdirect.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288137600000",
    "number": "1467445080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 MEDICAL PLAZA DR",
            "address_2": "SUITE 101",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347487326",
            "telephone_number": "352-728-6808",
            "fax_number": "352-728-1743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 MEDICAL PLAZA DR",
            "address_2": "SUITE 101",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347487326",
            "telephone_number": "352-728-6808",
            "fax_number": "352-728-1743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "TANYA",
        "middle_name": "I",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-30",
        "last_updated": "2010-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME90760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "270240100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "48179",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

Verify at the official NPI Registry.