Tristan Diaz, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

903153 Issued in MS

Practice address

75 Mount Auburn St
Cambridge, MA 02138-4960

Phone

(617) 384-5869

NPI assigned

Jan 7, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Tristan Green Former name

Medicare fee-for-service enrollment

Enrolled in MS, MA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

President and Fellows of Harvard CollegeGroup PAC ID 2062303894, 94 clinicians

Wiggins Primary CareGroup PAC ID 5890737019, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tristandiaz@grh.medalliesdirect.net
• FHIR API: https://fhir4.healow.com/fhir/r4/IBHCBA

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.

• President & Fellows of Harvard College

  dba Harvard University Health Services

  • Multi-Specialty Clinic/Center
  • Cambridge, MA
  • NPI 1952366312
  Medicare reassignment Care Compare group NPD
• Wiggins Primary Care

  • Rural Health Clinic/Center
  • Wiggins, MS
  • NPI 1740293257
  Medicare reassignment Care Compare group NPD
• Community Medical Center

  • Rural Health Clinic/Center
  • Lucedale, MS
  • NPI 1194734913
  Medicare reassignment NPD
• Greene County Family Medical Clinic

  • Rural Health Clinic/Center
  • Leakesville, MS
  • NPI 1689821126
  Medicare reassignment NPD
• President and Fellows of Harvard College

  dba Harvard Dental Center TP

  • General Practice Dentistry
  • Boston, MA
  • NPI 1972761807
  NPD
• George County Hospital

  • Rural Acute Care Hospital
  • Lucedale, MS
  • NPI 1023074028
  NPD
• Inpatient Physician Services

  • Hospitalist Physician
  • Lucedale, MS
  • NPI 1427363928
  NPD
• George Regional Radiology

  • Specialist
  • Lucedale, MS
  • NPI 1174775589
  NPD (past)

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

{
    "created_epoch": "1546819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1487127031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 WALDEN ST APT 1L",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021403513",
            "telephone_number": "601-508-4696",
            "fax_number": "601-947-1331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 MOUNT AUBURN ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021384960",
            "telephone_number": "617-384-5869"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "975 Hall St",
            "address_purpose": "LOCATION",
            "city": "Wiggins",
            "state": "MS",
            "postal_code": "395772107",
            "country_code": "US",
            "telephone_number": "601-528-9119",
            "fax_number": "601-528-9193",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "TRISTAN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-07",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-146825",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "903153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRISTAN",
            "last_name": "GREEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Olivia Diamond, M.D.
• Pamela F. Diamond, MD
• Louise Dias, PA
• Mariah Elizabeth Diaz, CPNP
• Sabrina Marie Diaz, DC
• Camille M Dibenedetto, PSYD
• Lauren Dickerman, O.D.
• Julia N Dickinson, CNM
• Rachelle Dickinson, OTR/L
• Samuel Diedhiou, M.ED

• Nurse Practitioner in Cambridge, MA
• Providers in Cambridge, MA by specialty
• Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.