Individual provider Active NPI

Diana I Huertas-Bauza

  • General Practice Physician
  • Bayamon, PR
National Provider Identifier
1689072175
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
23476 Issued in PR
Practice address
C17 Calle Marginal
Bayamon, PR 00961-6706
Phone
(787) 780-1273
Fax
(787) 786-8690
NPI assigned
Dec 15, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 23476 PR Primary

Addresses

Primary practice location

C17 Calle Marginal
Bayamon, PR 00961-6706

Mailing address

C17 Calle Marginal
Bayamon, PR 00961-6706
Phone (787) 780-1273

Other names 1

  • Dr. Diana I Huertas Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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 1

Enrollment IDStateProvider typePAC IDDetails
I20231031001281 PR Practitioner - General Practice 9436505211 Practice locations: Bayamon, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23476PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sana Corporacion P.T. PastSince Jun 1, 2020 Accepting new patients
Cooperativa de Grupos Medicos Primarios Ipacoop General Practice PastSince Jun 1, 2020 Accepting new patients

Organizations & group practices 2

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": "1418601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1689072175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "C17 CALLE MARGINAL",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009616706",
            "telephone_number": "787-780-1273",
            "fax_number": "787-786-8690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "C17 CALLE MARGINAL",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009616706",
            "telephone_number": "787-780-1273",
            "fax_number": "787-786-8690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUERTAS-BAUZA",
        "first_name": "DIANA",
        "middle_name": "I",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-15",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "23476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANA",
            "last_name": "HUERTAS",
            "middle_name": "I",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bayamon, PR

Sources for this page

Verify at the official NPI Registry.