Individual provider Active NPI

Miguel A. Roman-Diaz, M.D.

  • Sports Medicine (Family Medicine) Physician
  • San Juan, PR
National Provider Identifier
1679639785
Registry record updated Apr 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
9028 Issued in PR
Practice address
909 Calle Alameda
Villa Granada
San Juan, PR 00923-2719
Phone
(787) 755-7171
Fax
(787) 625-3227
NPI assigned
Jan 1, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 9028 PR Primary

Addresses

Primary practice location

909 Calle Alameda
Villa Granada
San Juan, PR 00923-2719

Mailing address

909 Calle Alameda
Villa Granada
San Juan, PR 00923-2719
Phone (787) 688-2779

Other names 1

  • Dr. Miguel A. Roman-Diaz Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NY2 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
I20090902000699 TX Practitioner - Family PracticePractitioner - General PracticePractitioner - Emergency Medicine 5799881157 Reassigns benefits to 1 organization
I20151015000216 NY Practitioner - Family Practice 5799881157 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
42.91 of 100Reported as group
Quality
5.54
Improvement activities
40
Cost
66.19

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9028PRMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Quentin N Burdick Comprehensive Health Care Facility CurrentSince Jul 27, 2022 Accepting new patients
Buffalo Emergency Associates LLP CurrentSince Mar 1, 2015 Accepting new patients
Emergency Physician Services of New York, P.C. Past Accepting new patients

Locations

1300 Hospital Loop
Belcourt, ND 58316

2157 Main St
Buffalo, NY 14214
Phone (716) 862-1501

2605 Harlem Rd
Cheektowaga, NY 14225
Phone (716) 891-2315

4100 W 150th St
#3
Cleveland, OH 44135

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.

NPI Registry JSON

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

{
    "created_epoch": "1167609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302652800000",
    "number": "1679639785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 CALLE ALAMEDA",
            "address_2": "VILLA GRANADA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009232719",
            "telephone_number": "787-688-2779",
            "fax_number": "787-625-3227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 CALLE ALAMEDA",
            "address_2": "VILLA GRANADA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009232719",
            "telephone_number": "787-755-7171",
            "fax_number": "787-625-3227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMAN-DIAZ",
        "first_name": "MIGUEL",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-01",
        "last_updated": "2011-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "PR",
            "license": "9028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIGUEL",
            "last_name": "ROMAN-DIAZ",
            "middle_name": "A.",
            "prefix": "DR.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.