Jessica H Diaz, MD

Individual provider Active NPI Family Medicine Physician · Medford, OR

NPI 1578645404 · NPPES record last updated Jan 23, 2020

Key facts

NPI
1578645404
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
MD25640 (OR)
Practice address
730 Biddle Rd
Medford, OR 97504-6116
Phone
(541) 494-3800
Fax
(541) 494-0895
NPI assigned
Oct 19, 2006
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Medicare Care Compare profile

Specialty
Family Practice
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
La Clinica del Valle Family Health Care Center Inc (59 clinicians)

Practice addresses (Care Compare)

730 Biddle Rd
Medford, OR 97504-6116
Phone (541) 494-3800

Hospital & facility affiliations

  • Asante Rogue Regional Medical Center Hospital · Medford, OR · CCN 380018
  • Providence Medford Medical Center Hospital · Medford, OR · CCN 380075

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20050725001076 OR Practitioner - Family Practice 1456388073 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD25640ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
La Clinica del Valle Family Health Care Center Inc. Current
since Sep 14, 2010
Accepting new patients
La Clinica del Valle Family Health Care Center Inc. Current
since Sep 14, 2010
Accepting new patients

Locations

931 Chevy Way
Medford, OR 97504
Phone (541) 690-3555

1307 W Main St
Medford, OR 97501
Phone (541) 618-1314

730 Biddle Rd
Medford, OR 97504
Phone (541) 210-5674

3617 S Pacific Hwy
Medford, OR 97501
Phone (541) 512-3182

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD25640 OR Yes

Addresses

Primary practice location

730 Biddle Rd
Medford, OR 97504-6116

Mailing address

931 Chevy Way
Medford, OR 97504-4127
Phone (541) 690-3555

Other providers in Medford, OR

All providers in Medford, OR · Family Medicine Physician in Oregon

Sources for this page

Verify at the official NPI Registry.