Derek Diaz, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95021897 Issued in CA

Practice address

2821 S Cascades TRL
Ontario, CA 91761-7234

Phone

(909) 732-0197

NPI assigned

Sep 13, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Nurse Practitioner

Education

Western Un of HLTH Sciences, Col of Podiatric Med, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Michael Decker DO, Inc.Group PAC ID 9830481746, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Michael Decker, DO, Inc

  • Skilled Nursing Facility
  • Hermosa Beach, CA
  • NPI 1528410842

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Bristol Hospice - Inland Empire, LLC

  • Community Based Hospice Care Agency
  • Riverside, CA
  • NPI 1043683170
  NPD

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

{
    "created_epoch": "1663027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663027200000",
    "number": "1831811157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2821 S CASCADES TRL",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917617234",
            "telephone_number": "909-732-0197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2821 S CASCADES TRL",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917617234",
            "telephone_number": "909-732-0197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "DEREK",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-13",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95021897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Valeria Diaz Ochoa
• Arlene Diaz-Cervantes
• Alejandra Diaz
• Andrea Diaz, OTR/L
• Brett Edward Diaz, D.C.
• Evelyn Daniella Diaz
• Gemma Diaz
• Irwin Alexander Diaz
• Jacqueline Diaz
• Lisa C Diaz, AMFT

• Nurse Practitioner in Ontario, CA
• Providers in Ontario, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; 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.