Diab Medical Group

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

DIAB MEDICAL GROUP

Practice address

108 Wild Basin Rd Ste 250
West Lake Hills, TX 78746-3468

Phone

(415) 644-8466

NPI assigned

Dec 5, 2017

Reactivated

Apr 10, 2019

Organization subpart

No

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

Authorized official

Name

Carisa Quintana

Title

Administrator

Phone

(415) 644-8466

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ma Nehemiah Valencia Galindo, NP

  • Nurse Practitioner
  • Santa Ana, CA
  • NPI 1184113292
  NPD (past)
• Ian R. Johnson, M.D.

  • Family Medicine Physician
  • French Camp, CA
  • NPI 1265454706
  NPD (past)
• Omayra Lizardo, LCSW

  • Clinical Social Worker
  • Doral, FL
  • NPI 1023301298
  NPD (past)

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

{
    "created_epoch": "1512432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588204800000",
    "number": "1750896395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13492 RESEARCH BLVD STE 120-176",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787502252",
            "telephone_number": "415-644-8466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 WILD BASIN RD STE 250",
            "city": "WEST LAKE HILLS",
            "state": "TX",
            "postal_code": "787463468",
            "telephone_number": "415-644-8466"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Lawson Ln",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "VT",
            "postal_code": "054018445",
            "country_code": "US",
            "telephone_number": "415-644-8466",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1515 Market St Ste 1200",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191021932",
            "country_code": "US",
            "telephone_number": "415-644-8466",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5200 Meadows Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Lake Oswego",
            "state": "OR",
            "postal_code": "970350086",
            "country_code": "US",
            "telephone_number": "415-644-8466",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8101 College Blvd",
            "address_purpose": "LOCATION",
            "city": "Overland Park",
            "state": "KS",
            "postal_code": "662101978",
            "country_code": "US",
            "telephone_number": "415-644-8466",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13492 Research Blvd Ste 120-176",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "78750",
            "country_code": "US",
            "telephone_number": "415-644-8466",
            "fax_number": "512-957-2060",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4000 Eagle Point Corporate Dr",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352421900",
            "country_code": "US",
            "telephone_number": "415-644-8466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DIAB MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-05",
        "last_updated": "2020-04-30",
        "certification_date": "2020-04-30",
        "deactivation_date": "2019-04-01",
        "reactivation_date": "2019-04-10",
        "status": "A",
        "authorized_official_last_name": "QUINTANA",
        "authorized_official_first_name": "CARISA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "415-644-8466"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adam Michael Decker, PA
• Natallie Degante
• Ashley Nicole Deleon, M.D., PHARM.D.
• Lauren Theresa Devall, OTA/L
• Matthew Jacob Dewit, LCSW
• Jose Luis Diaz III, DPT
• Michelle Beatriz Diaz
• Natalie L Dickey, LPC-A
• Rachael Dieter
• Katherin Dillingham, LPC

• Family Medicine Physician in West Lake Hills, TX
• Providers in West Lake Hills, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.