Bernardo Fabian Diaz Jr., M.D.

Primary specialty

Surgical Critical Care PhysicianTaxonomy code 2086S0102X

License

D98084 Issued in MD

Practice address

11110 Medical Campus Rd Ste 143
Hagerstown, MD 21742-6755

Phone

(301) 714-4350

NPI assigned

May 26, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Enrolled in MO, MD2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

General Surgery

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medical Practices of Antietam, LLCGroup PAC ID 2567353865, 229 clinicians

Meritus Medical Center IncGroup PAC ID 7113811795, 730 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Meritus Medical Center Hospital, Hagerstown, MD, CCN 210001

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Medical Practices of Antietam LLC

  • Clinic/Center
  • Hagerstown, MD
  • NPI 1710854963
  Medicare reassignment Care Compare group NPD
• Meritus Medical Center Inc

  • Nurse Practitioner
  • Hagerstown, MD
  • NPI 1205176393
  Medicare reassignment Care Compare group NPD
• Mercy Clinic Springfield Communities

  • Rural Health Clinic/Center
  • Willow Springs, MO
  • NPI 1972771657
  Medicare reassignment
• Medical Practices of Antietam, LLC

  • General Practice Physician
  • Hagerstown, MD
  • NPI 1558430843
  NPD
• Meritus Medical Center Inc

  • Diagnostic Radiology Physician
  • Hagerstown, MD
  • NPI 1184477911
  NPD
• Mercy Clinic Springfield Communities

  • Family Medicine Physician
  • Hollister, MO
  • NPI 1053350454
  NPD
• Pottstown Clinic Company LLC

  • Family Medicine Physician
  • Pottstown, PA
  • NPI 1649341934

  Surgery

  NPD
• Tower Health Medical Group

  • Internal Medicine Physician
  • Birdsboro, PA
  • NPI 1609291350
  NPD
• Tower Health Medical Group

  • Neonatal-Perinatal Medicine Physician
  • West Reading, PA
  • NPI 1679843288
  NPD
• Tower Health Medical Group

  • Surgery Physician
  • Wyomissing, PA
  • NPI 1831954353
  NPD
• Meritus Medical Center Inc

  • Cardiac Rehabilitation Clinic/Center
  • Hagerstown, MD
  • NPI 1245256213
  NPD (past)
• Meritus Medical Center Inc

  • General Acute Care Hospital
  • Hagerstown, MD
  • NPI 1942281266
  NPD (past)

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

• Meritus Medical Center Inc

  • General Acute Care Hospital
  • Hagerstown, MD
  • NPI 1942281266
  Care Compare affiliation

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

{
    "created_epoch": "1432598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1609255447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11110 MEDICAL CAMPUS RD STE 143",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217426755",
            "telephone_number": "301-714-4350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11110 MEDICAL CAMPUS RD STE 143",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217426755",
            "telephone_number": "301-714-4350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1965 S Fremont Ave Ste 230",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658042258",
            "country_code": "US",
            "telephone_number": "417-820-7250",
            "fax_number": "417-820-7255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "BERNARDO",
        "middle_name": "FABIAN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-26",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "654947",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2022030140",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "PA",
            "license": "MD473032",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "MD",
            "license": "D98084",
            "primary": true
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "MO",
            "license": "2022030140",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "MO",
            "license": "2022030140",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diakon Lutheran Senior Living-Maryland Ravenwood Campus
• Diakon Lutheran Social Minsitries
• Ramata Diallo
• Dialog Healthcare LLC
• Fiona Dias
• Caitlin Alexandra Dichiara
• Calista Christine Dickey, L. AC., DIPL. AC.
• Matthew S Dicks, DPT
• Lauren Dietrich, RDH
• Thomas L Diggs, DNP, AAS

• Surgical Critical Care Physician in Hagerstown, MD
• Providers in Hagerstown, MD by specialty
• Surgical Critical Care Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2023; 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.