Individual provider Active NPI

Christopher Diaz, PA-C

  • Medical Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1821594391
Registry record updated Nov 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA059723 Issued in PA
Practice address
1233 Locust St
Philadelphia, PA 19107-5453
Phone
(215) 985-4448
NPI assigned
Apr 3, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA059723 PA
Medical Physician Assistant 363AM0700X MA059723 PA Primary

Addresses

Primary practice location

1233 Locust St
Philadelphia, PA 19107-5453

Mailing address

1233 Locust St
Philadelphia, PA 19107-5453
Phone (215) 985-4448

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230404002786 PA Practitioner - Physician Assistant 9537534524 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA059723PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Philadelphia Fight CurrentSince Feb 21, 2024 Accepting new patients
Avenues Recovery Medical Center at Valley Forge CurrentSince Nov 17, 2022 Accepting new patients
Aviva, LLC PastSince Feb 4, 2024 Accepting new patients

Locations

850 Towbin Ave
Lakewood, NJ 08701
Phone (732) 886-6202

1033 W Germantown Pike
Norristown, PA 19403
Phone (610) 539-8500

1233 Locust St
Ste 500
Philadelphia, PA 19107
Phone (215) 790-1788

1233 Locust St
Fl 45
Philadelphia, PA 19107

1233 Locust St
Fl 3
Philadelphia, PA 19107
Phone (267) 725-0252

1233 Locust St
Philadelphia, PA 19107
Phone (215) 790-1788

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.

NPI Registry JSON

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

{
    "created_epoch": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699574400000",
    "number": "1821594391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1233 LOCUST ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075453",
            "telephone_number": "215-985-4448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1233 LOCUST ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075453",
            "telephone_number": "215-985-4448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "CHRISTOPHER",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-03",
        "last_updated": "2023-11-10",
        "certification_date": "2023-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA059723",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA059723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.