Individual provider Active NPI

Maidel Diaz, OT19265

  • Occupational Therapist
  • Doral, FL
National Provider Identifier
1497156491
Registry record updated Jul 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT19265 Issued in FL
Practice address
3655 NW 107TH Ave Ste 107
Doral, FL 33178-4328
Phone
(786) 452-0774
NPI assigned
Sep 9, 2014
Last updated
Jul 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT19265 FL Primary

Addresses

Primary practice location

3655 NW 107TH Ave Ste 107
Doral, FL 33178-4328

Mailing address

PO Box 331934
Miami, FL 33233-1934
Phone (786) 452-0774

Other practice location 1

10051 Dominican Dr
Cutler Bay, FL 33189-1659
Phone (305) 298-7797

Other names 1

  • Maidel Diaz Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220125000319 FL Practitioner - Occupational Therapist in Private Practice 9537551585 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2017
Medicare assignment
May accept Medicare assignment
Group practices
Pinecrest PT-South LLCGroup PAC ID 9436413077, 6 clinicians

Practice addresses (Care Compare)

13101 S Dixie Hwy
Suite 330
Miami, FL 33156-6530
Phone (786) 732-7438

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Doral Physical Therapy L.L.C. CurrentSince Dec 1, 2021 Accepting new patients
Pinecrest PT-South L.L.C. CurrentSince Dec 1, 2021 Accepting new patients
Bio Networks Inc CurrentSince May 15, 2023 Accepting new patients

Locations

3655 NW 107th Ave
Ste 107
Doral, FL 33178
Phone (786) 452-0774

1441 SW 1st St
Miami, FL 33135
Phone (305) 541-3400

13101 S Dixie Hwy
Ste 330
Pinecrest, FL 33156
Phone (786) 732-7438

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.

NPI Registry JSON

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

{
    "created_epoch": "1410220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1497156491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 331934",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "332331934",
            "telephone_number": "786-452-0774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3655 NW 107TH AVE STE 107",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331784328",
            "telephone_number": "786-452-0774"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10051 Dominican Dr",
            "address_purpose": "LOCATION",
            "city": "Cutler Bay",
            "state": "FL",
            "postal_code": "331891659",
            "country_code": "US",
            "telephone_number": "305-298-7797",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "MAIDEL",
        "credential": "OT19265",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-09",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT19265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAIDEL",
            "last_name": "DIAZ",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Doral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 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.
  • 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.