Individual provider Active NPI

Luis Miguel Diaz, M.D.

  • General Practice Physician
  • Arecibo, PR
National Provider Identifier
1821134297
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
8248 Issued in PR
Practice address
175 Calle San Felipe
Arecibo, PR 00612-4605
Phone
(787) 879-3995
Fax
(787) 650-1385
NPI assigned
Jan 30, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 8248 PR
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X 8248 PR Primary

Addresses

Primary practice location

175 Calle San Felipe
Arecibo, PR 00612-4605

Mailing address

158 Calle San Felipe
Arecibo, PR 00612
Phone (787) 879-3995

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
I20040420000989 PR Practitioner - General Practice 6800881566 Practice locations: Arecibo, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

175 Calle San Felipe
Arecibo, PR 00612-4605
Phone (787) 879-3995

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8248PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
LMDC Primary Medicine LLC Single Specialty CurrentSince Jul 10, 2022 Accepting new patients
Farmacia Marilu Past Accepting new patients

Locations

175 Calle San Felipe
Arecibo, PR 00612
Phone (787) 879-3995

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.

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1821134297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 CALLE SAN FELIPE",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "00612",
            "telephone_number": "787-879-3995",
            "fax_number": "787-879-3995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 CALLE SAN FELIPE",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "006124605",
            "telephone_number": "787-879-3995",
            "fax_number": "787-650-1385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "LUIS",
        "middle_name": "MIGUEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "PR",
            "license": "8248",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "PR",
            "license": "8248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arecibo, PR

Sources for this page

Verify at the official NPI Registry.