Individual provider Active NPI

Joselyn Diaz, PA-C

  • Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1508498148
Registry record updated Oct 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
58303 Issued in CA
Practice address
808 W 58TH St
Los Angeles, CA 90037-3632
Phone
(323) 541-1411
NPI assigned
Feb 11, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 58303 CA Primary

Addresses

Primary practice location

808 W 58TH St
Los Angeles, CA 90037-3632

Mailing address

PO Box 43264
Los Angeles, CA 90043-0264
Phone (213) 357-9254

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20210622002518 CA Practitioner - Physician Assistant 3072914522 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. John'S Community HealthGroup PAC ID 2961482690, 151 clinicians

Practice addresses (Care Compare)

15301 S San Jose Ave
Compton, CA 90221-3131
Phone (562) 630-6825

2115 N Wilmington Ave
Compton, CA 90222-2030
Phone (310) 603-1332

5701 S Hoover St
Los Angeles, CA 90037-4045
Phone (323) 541-1411

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
St. Johns Community Health CurrentSince Mar 11, 2021 Accepting new patients
St. Johns Community Health CurrentSince Mar 11, 2021 Accepting new patients
St. Johns Community Health Past Accepting new patients

Locations

2115 N Wilmington Ave
Compton, CA 90222
Phone (310) 603-1332

15301 S San Jose Ave
Compton, CA 90221
Phone (562) 630-6825

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1581379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602720000000",
    "number": "1508498148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43264",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900430264",
            "telephone_number": "213-357-9254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 W 58TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900373632",
            "telephone_number": "323-541-1411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "JOSELYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-11",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "58303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.