Clarissa K Diaz, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1367514 Issued in TX

Practice address

13472 Eastlake Blvd
Horizon City, TX 79928-7992

Phone

(915) 296-3005

Fax

(915) 296-3013

NPI assigned

Sep 1, 2022

Last updated

Sep 1, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NM, TX2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Back in Action TherapyGroup PAC ID 4486622628, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Back in Action Therapy LLC

  • Physical Therapist
  • Alamogordo, NM
  • NPI 1043386188
  Medicare reassignment Care Compare group NPD
• El Paso Back in Action Therapy, LLC

  • Physical Therapist
  • El Paso, TX
  • NPI 1194606293
  Medicare reassignment NPD

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

{
    "created_epoch": "1661990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1649990292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4758 LOMA DEL SUR DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799343597",
            "telephone_number": "915-755-6941",
            "fax_number": "915-755-6941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13472 EASTLAKE BLVD",
            "city": "HORIZON CITY",
            "state": "TX",
            "postal_code": "799287992",
            "telephone_number": "915-296-3005",
            "fax_number": "915-296-3013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "CLARISSA",
        "middle_name": "K",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-01",
        "last_updated": "2022-09-01",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1367514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "clarissa.diaz@fyzical.com",
            "affiliation": "N",
            "endpointDescription": "business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "13472 Eastlake Blvd",
            "city": "Horizon City",
            "state": "TX",
            "country_code": "US",
            "postal_code": "799287992",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Timothy John Dalimata, FNP
• Steven M Delgado
• Dental Health Associates of TX, P.C. (Darrington Dental Care)
• Jerusalem Desion, LPC
• Diana Escobedo MD PA
• Andrew J Dyer, DDS
• E & J Family Health Center PLLC (Horizon Family Physician)
• Empower and Evolve, LLC
• Diana Escobedo, M.D.
• Perla Esparza, MD

• Physical Therapist in Horizon City, TX
• Providers in Horizon City, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 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.