Individual provider Active NPI

Jorge M Diego, MD

  • Nephrology Physician
  • Shelbyville, IN
National Provider Identifier
1669400198
Registry record updated Oct 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
01077464A Issued in IN
Practice address
2451 Intelliplex Dr Ste 260
Shelbyville, IN 46176-8580
Phone
(317) 398-0121
NPI assigned
Jun 30, 2006
Last updated
Oct 12, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 01077464A IN
Nephrology Physician 207RN0300X 01077464A IN Primary

Addresses

Primary practice location

2451 Intelliplex Dr Ste 260
Shelbyville, IN 46176-8580

Mailing address

2451 Intelliplex Dr
Ste 260
Shelbyville, IN 46176-8580
Phone (305) 243-4664

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, IN2 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

Enrollment IDStateProvider typePAC IDDetails
I20101129000989 FL Practitioner - NephrologyPractitioner - Internal MedicinePractitioner - Infectious Disease 1254527559 Reassigns benefits to 1 organization
I20160826001026 IN Practitioner - Internal Medicine 1254527559 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Florida College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Major Multispecialty AssociatesGroup PAC ID 6305997842, 39 clinicians

Practice addresses (Care Compare)

2451 Intelliplex Dr
Suite 210
Shelbyville, IN 46176-8581
Phone (317) 421-1914

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Major Multispecialty Associates CurrentSince Oct 1, 2016 Accepting new patients
Major Multispecialty Associates Nephrology CurrentSince Oct 1, 2016 Accepting new patients
Kidney Specialty Center Inc. Nephrology CurrentSince Nov 27, 2017 Accepting new patients
Major Hospital Past Accepting new patients

Locations

1626 E State Road 44
Ste A
Shelbyville, IN 46176
Phone (317) 421-2012

2451 Intelliplex Dr
#210
Shelbyville, IN 46176
Phone (317) 421-1914

2451 Intelliplex Dr
Ste 210
Shelbyville, IN 46176
Phone (317) 421-1914

2451 Intelliplex Dr
Ste 260
Shelbyville, IN 46176
Phone (317) 398-0121

30 W Rampart St
Ste 200
Shelbyville, IN 46176
Phone (317) 398-0121

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

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1669400198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2451 INTELLIPLEX DR",
            "address_2": "STE 260",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "461768580",
            "telephone_number": "305-243-4664",
            "fax_number": "305-243-9927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2451 INTELLIPLEX DR STE 260",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "461768580",
            "telephone_number": "317-398-0121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEGO",
        "first_name": "JORGE",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "IN",
            "license": "01077464A",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IN",
            "license": "01077464A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelbyville, IN

Sources for this page

Verify at the official NPI Registry.