Individual provider Active NPI

Diego Puentes, DO

  • Emergency Medicine Physician
  • Fresno, CA
National Provider Identifier
1811571102
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
011288 Issued in AZ
Practice address
1303 E Herndon Ave
Fresno, CA 93720-3309
Phone
(559) 450-3000
NPI assigned
May 12, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 011288 AZ Primary

Addresses

Primary practice location

1303 E Herndon Ave
Fresno, CA 93720-3309

Mailing address

1583 Sonora St
Madera, CA 93638-1592
Phone (559) 871-8798

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20241002003570 AZ Practitioner - Emergency Medicine 3870024771 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sierra Estrellas Emergency Physicians LLCGroup PAC ID 5193002954, 38 clinicians

Practice addresses (Care Compare)

2400 S Ave a
Yuma, AZ 85364-7127
Phone (928) 344-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
011288AZMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sierra Estrellas Emergency Physicians LLC Emergency Medicine CurrentSince Sep 12, 2024 Accepting new patients
Yuma Regional Medical Center Past Accepting new patients

Locations

1500 S Mill Ave
Tempe, AZ 85281
Phone (480) 784-5500

2400 S Avenue A
Yuma, AZ 85364
Phone (928) 336-7100

11351 S Frontage Rd
Yuma, AZ 85367
Phone (928) 336-2000

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1620777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1811571102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1583 SONORA ST",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936381592",
            "telephone_number": "559-871-8798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 E HERNDON AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203309",
            "telephone_number": "559-450-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUENTES",
        "first_name": "DIEGO",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-12",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "011288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.