Wanda I. Diaz, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

27633 Issued in OK

Practice address

1902 E Gore Blvd
Lawton, OK 73501-6102

Phone

(580) 357-4200

NPI assigned

Jun 11, 2007

Last updated

Oct 1, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

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

Specialty

Emergency Medicine

Education

University of Puerto Rico School of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Xgto Urgent Medical of Lawton, LLCGroup PAC ID 4789863267, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Xgto Urgent Medical of Lawton, LLC

  dba WellFast Urgent Care Center East

  • Urgent Care Clinic/Center
  • Lawton, OK
  • NPI 1891027371
  Medicare reassignment Care Compare group NPD
• Emergency Medicine South LLC

  • Emergency Medicine Physician
  • Valdosta, GA
  • NPI 1194785170
  NPD (past)

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349049600000",
    "number": "1801090329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1902 E GORE BLVD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735016102",
            "telephone_number": "580-357-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1902 E GORE BLVD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735016102",
            "telephone_number": "580-357-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "WANDA",
        "middle_name": "I.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-11",
        "last_updated": "2012-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "038217",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "27633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Dever
• Kellie Rose Devine
• John W Dew II, CRNA
• Grant Kevin Dewitt, DO
• Jenna Dial
• James Alfred Dick, DDS
• Tia Dickinson, LPN
• Karisma Dickson
• Marsha Diggs-Tarin, RN
• Patricia E Dileo, LPC

• Emergency Medicine Physician in Lawton, OK
• Providers in Lawton, OK by specialty
• Emergency Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2012; 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.