NPIMap

Individual provider Active NPI

Marvin Diaz-Lacayo, M.D.

  • Internal Medicine Physician
  • Dorchester Center, MA
National Provider Identifier
1477590214
Registry record updated Oct 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
223423 Issued in MA
Practice address
2100 Dorchester Ave
Dorchester Center, MA 02124-5615
Phone
(617) 296-4000
Fax
(617) 474-3856
NPI assigned
Jun 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 223423 MA Primary

Addresses

Primary practice location

2100 Dorchester Ave
Dorchester Center, MA 02124-5615

Mailing address

2100 Dorchester Ave
Dorchester Center, MA 02124-5615
Phone (617) 506-4901

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20060802000511 MA Practitioner - Internal Medicine 6709899024 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tufts Medical Center Community Care IncGroup PAC ID 4981915659, 21 clinicians

Practice addresses (Care Compare)

1690 Crown Colony Dr
Quincy, MA 02169-0913
Phone (857) 403-4600

Hospital & facility affiliations

  • South Shore Visiting Nurse Association Home health agency, Rockland, MA, CCN 227082
  • South Shore Hospital Hospital, South Weymouth, MA, CCN 220100
  • Beth Israel Deaconess Hospital - Milton Hospital, Milton, MA, CCN 220108
  • Beth Israel Deaconess Medical Center Hospital, Boston, MA, CCN 220086
  • Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110
  • Tufts Medical Center Hospital, Boston, MA, CCN 220116
  • Spaulding Rehabilitation Hospital Inpatient rehabilitation facility, Charlestown, MA, CCN 223034
  • Boston Home, Inc (the) Nursing home, Boston, MA, CCN 225434

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Medical Group, Inc CurrentSince Nov 6, 2010 Accepting new patients
Steward Medical Group, Inc CurrentSince Nov 6, 2010 Accepting new patients
Tufts Medical Center Community Care, Inc Internal Medicine CurrentSince Feb 1, 2018 Accepting new patients
Boston Home Inc Past Accepting new patients
Carney Medical Group Past Accepting new patients
Southeast Anesthesia Assoc Past Accepting new patients
Boston Medical Group, PC Past Accepting new patients

Locations

325 Wood Rd
Ste 210
Braintree, MA 02184
Phone (781) 356-3336

11 Nevins St
Brighton, MA 02135
Phone (617) 562-2782

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

2100 Dorchester Ave
Dorchestr Ctr, MA 02124
Phone (617) 506-2222

2100 Dorchester Ave
Fl 7
Dorchestr Ctr, MA 02124
Phone (617) 296-4012

100 Amesbury St
Ste 103
Lawrence, MA 01840
Phone (978) 683-0157

1690 Crown Colony Dr
Quincy, MA 02169
Phone (781) 237-3395

40 Spring St
Watertown, MA 02472
Phone (617) 923-8433

Interoperability endpoints

  • Direct secure messaging: mdiazlacayo29842@tuftsmedicine.direct-ci.com

Organizations & group practices 7

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.

Hospital & facility affiliations 8

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": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318982400000",
    "number": "1477590214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 DORCHESTER AVE",
            "city": "DORCHESTER CENTER",
            "state": "MA",
            "postal_code": "021245615",
            "telephone_number": "617-506-4901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 DORCHESTER AVE",
            "city": "DORCHESTER CENTER",
            "state": "MA",
            "postal_code": "021245615",
            "telephone_number": "617-296-4000",
            "fax_number": "617-474-3856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ-LACAYO",
        "first_name": "MARVIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2011-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "223423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorchester Center, MA

Sources for this page

Verify at the official NPI Registry.