Ionn Carlo Yamba Diaz, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP145555 Issued in TX

Practice address

24285 Katy Fwy Ste 300
Katy, TX 77494-1327

Phone

(713) 486-5452

Fax

(713) 512-7104

NPI assigned

Mar 9, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Collaborative Geriatrics IncGroup PAC ID 5193827046, 45 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: idiaz46844@direct.uth.org

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.

• Collaborative Geriatrics Inc

  • Gerontology Nurse Practitioner
  • Katy, TX
  • NPI 1811088628
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1583712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1629603790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2902 ASHWOOD ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770253210",
            "telephone_number": "562-652-8878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24285 KATY FWY STE 300",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774941327",
            "telephone_number": "713-486-5452",
            "fax_number": "713-512-7104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "IONN CARLO",
        "middle_name": "YAMBA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-09",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP145555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "417539001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristen Diao, MD
• Luis Norberto Diaz Gonzalez
• Abigail Diaz
• Belen Patricia Diaz, DDS
• Carmen Esmeralda Diaz
• Jose M Diaz, M.D.
• Richard Diaz, DDS
• Thomas Guerra Diaz, MD
• Wenndy P Dicesare, MS-SLP
• Jazmine A Dickerson, RBT

• Nurse Practitioner in Katy, TX
• Providers in Katy, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.