Individual provider Active NPI

Angel J Miro-Diaz, MD

  • Internal Medicine Physician
  • San Juan, PR
National Provider Identifier
1821064346
Registry record updated Jun 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
9630 Issued in PR
Practice address
369 De Diego Ave
Torre San Francisco Suite 507
San Juan, PR 00923
Phone
(787) 282-3000
Fax
(787) 767-2272
NPI assigned
Feb 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 9630 PR Primary

Addresses

Primary practice location

369 De Diego Ave
Torre San Francisco Suite 507
San Juan, PR 00923

Mailing address

PO Box 29586
San Juan, PR 00929-0586
Phone (787) 282-3000

Other identifiers 5

IdentifierTypeStateIssuer
81914OtherPRTRIPLE-S
2723OtherPRPREFERRED MEDICARE CHOICE
9250092OtherPRHUMANA
29639OtherPRMCS
991746OtherPRMMM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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
I20110518000204 PR Practitioner - Internal MedicinePractitioner - Other (Physician) 7517143001 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

369 Calle de Diego
San Juan, PR 00923-3003
Phone (787) 282-3000

Hospital & facility affiliations

  • Hospital San Francisco Hospital, San Juan, PR, CCN 400098

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Angel Miro Diaz, PSC Internal Medicine CurrentSince Oct 19, 2014 Accepting new patients

Locations

369 Calle de Diego
Ste 507
San Juan, PR 00923

Organizations & group practices 1

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 2

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": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372291200000",
    "number": "1821064346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 29586",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009290586",
            "telephone_number": "787-282-3000",
            "fax_number": "787-282-3080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "369 DE DIEGO AVE",
            "address_2": "TORRE SAN FRANCISCO SUITE 507",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00923",
            "telephone_number": "787-282-3000",
            "fax_number": "787-767-2272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRO-DIAZ",
        "first_name": "ANGEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2013-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "9630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIPLE-S",
            "identifier": "81914",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED MEDICARE CHOICE",
            "identifier": "2723",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "9250092",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCS",
            "identifier": "29639",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MMM",
            "identifier": "991746",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.