Jose F Diaz, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

MA56920 Issued in NJ

Practice address

20 Magnolia Ave
Ste D
Bridgetown, NJ 08302

Phone

(856) 455-5770

Fax

(856) 453-8458

NPI assigned

Nov 24, 2006

Sex

Male

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467528299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 MAGNOLIA AVE",
            "address_2": "STE D",
            "city": "BRIDGETOWN",
            "state": "NJ",
            "postal_code": "08302",
            "telephone_number": "856-455-5770",
            "fax_number": "856-453-8458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 MAGNOLIA AVE",
            "address_2": "STE D",
            "city": "BRIDGETOWN",
            "state": "NJ",
            "postal_code": "08302",
            "telephone_number": "856-455-5770",
            "fax_number": "856-453-8458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "JOSE",
        "middle_name": "F",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NJ",
            "license": "MA56920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5071500",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.