Gustavo A Diaz, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1074 Issued in SD

Practice address

911 E. 20TH St.
Ste. 300
Sioux Falls, SD 57105-1045

Phone

(605) 322-1300

Fax

(605) 322-1301

NPI assigned

Jun 16, 2006

Sex

Male

Sole proprietor

No

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.

• Grand Strand Specialty Associates, LLC

  • Orthopaedic Surgery Physician
  • Myrtle Beach, SC
  • NPI 1821398512

  SC

  Medicare reassignment Care Compare group
• Health Services of Central Georgia, Inc

  • Multi-Specialty Clinic/Center
  • Macon, GA
  • NPI 1184679482

  GA

  Medicare reassignment Care Compare group
• Acute Care Surgery of South Dakota PC

  • Orthopaedic Surgery Physician
  • Rapid City, SD
  • NPI 1730797184

  SD

  Medicare reassignment
• Avera McKennan

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Sioux Falls, SD
  • NPI 1699009944

  SD

  Medicare reassignment
• Acute Care Surgical Affiliates of Texas PA

  • Surgery Physician
  • Corpus Christi, TX
  • NPI 1407322415

  TX

  Medicare reassignment
• Susquehanna Physician Services

  • Cardiovascular Disease Physician
  • Williamsport, PA
  • NPI 1861431116

  PA

  Medicare reassignment
• Avera McKennan

  • Diagnostic Radiology Physician
  • Sioux Falls, SD
  • NPI 1053680678
  NPD
• Avera McKennan

  • Otolaryngology Physician
  • Sioux Falls, SD
  • NPI 1316601743
  NPD
• Susquehanna Physician Services

  • Radiology Clinic/Center
  • Mansfield, PA
  • NPI 1073361564
  NPD
• Susquehanna Physician Services

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Williamsport, PA
  • NPI 1831395912

  Physician Assistant

  NPD
• Acute Orthopedic Care Specialists PLLC

  • Orthopaedic Surgery Physician
  • Odessa, TX
  • NPI 1922254572
  NPD (past)
• Acute Surgical Care Specialists PLLC

  • Surgery Physician
  • Plano, TX
  • NPI 1184837403
  NPD (past)
• Greater Northwest Houston Enterprises

  • Family Medicine Physician
  • Houston, TX
  • NPI 1881617215
  NPD (past)
• Reliance Orthopedic and Sports Medicine PLLC

  • Orthopaedic Surgery Physician
  • Fort Worth, TX
  • NPI 1790168060
  NPD (past)

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

• Grand Strand Regional Medical Center LLC

  • General Acute Care Hospital
  • Myrlte Beach, SC
  • NPI 1083668669

  Hospital

  Care Compare affiliation
• Macon Northside Hospital, LLC

  • General Acute Care Hospital
  • Macon, GA
  • NPI 1811940976

  Hospital

  Care Compare affiliation
• The Medical Center of Central Georgia Inc

  • General Acute Care Hospital
  • Macon, GA
  • NPI 1043270564

  Hospital

  Care Compare affiliation

Specialty

Physician Assistant

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Health Services of Central Georgia 300 clinicians

Grand Strand Specialty Associates, LLC 29 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Atrium Health Navicent the Medical Center Hospital, Macon, GA, CCN 110107
• Grand Strand Regional Medical Center Hospital, Myrtle Beach, SC, CCN 420085
• Piedmont Macon North Hospital Hospital, Macon, GA, CCN 110201

Medicare fee-for-service enrollment

Enrolled in TX, SD, GA, PA, SC5 enrollments

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gustavo.diaz.p19@direct.tenet.nextgenshare.com

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2025.

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1730123977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 E. 20TH ST.",
            "address_2": "STE. 300",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051045",
            "telephone_number": "605-322-1300",
            "fax_number": "605-322-1301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 E. 20TH ST.",
            "address_2": "STE. 300",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051045",
            "telephone_number": "605-322-1300",
            "fax_number": "605-322-1301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "GUSTAVO",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA03831",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9102123",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "5560",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "1074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yvonne Dewitte
• Diabetes and Endocrine Clinic
• Diana Cruz Therapy LLC
• Taylor Ann Dias, M.A., CCC-SLP
• Santiago Diaz Gonzalez
• Marie Angelica Landicho Diaz, M.D.
• Megan Dibble, OTD, OTR/L
• Catherine J Dice, RN,CCT,RDCS,RCS,LPN
• Sheri Dickens
• Todd Alan Dickens, PHARMACIST

• All providers in Sioux Falls, SD
• Physician Assistant in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2025; 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.