Active NPI
Johnathen Diaz, MD
- Anesthesiology Physician
- Ann Arbor, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- ME167144
- Practice address
- 1500 E. Medical Center Dr
1H247
Ann Arbor, MI 48109 - Phone
- (734) 936-4280
- NPI assigned
- Jun 19, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | ME167144 | FL | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | 4351046251 | MI |
Addresses
Primary practice location
1500 E. Medical Center Dr
1H247
Ann Arbor, MI 48109
Mailing address
1500 E. Medical Center Dr
1H247
Ann Arbor, MI 48109
Phone (734) 936-4280
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Tampa General Cir
Tampa, FL 33606-3571
Phone (813) 844-4396
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gulf-to-Bay Anesthesiology Associates LLC | Anesthesiology | Current | Accepting new patients |
| Tampa General Hospital | Current | Accepting new patients | |
| Gulf-to-Bay Anesthesiology Associates LLC | Anesthesiology | Current | Accepting new patients |
Locations
24040 Tamiami Trl
Bonita Springs, FL 34134
Phone (239) 624-7153
15238 Virginia Sta
Odessa, FL 33556
Phone (813) 596-5200
1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-5822
265 Brookview Centre Way
Ste 203
Knoxville, TN 37919
Phone (865) 500-1254
Interoperability endpoints
- jdiaz3105655@direct.trinity-health.org
- https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
- jdiaz299537@direct.tgh.org
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.
-
- Anesthesiology Physician
- Tampa, FL
- NPI 1720039746
-
- Anesthesiology Physician
- Largo, FL
- NPI 1316205339
-
- General Acute Care Hospital
- Tampa, FL
- NPI 1124558929
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Tampa, FL
- NPI 1235196510
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721260800000",
"number": "1790301364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 E. MEDICAL CENTER DR",
"address_2": "1H247",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "48109",
"telephone_number": "734-936-4280"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 E. MEDICAL CENTER DR",
"address_2": "1H247",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "48109",
"telephone_number": "734-936-4280"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAZ",
"first_name": "JOHNATHEN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-06-19",
"last_updated": "2024-07-18",
"certification_date": "2024-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "FL",
"license": "ME167144",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MI",
"license": "4351046251",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; 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.