Individual provider Active NPI

Eddy Silvano Diaz Godoy, DC

  • Chiropractor
  • San Juan, PR
National Provider Identifier
1861132623
Registry record updated Apr 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
817 Issued in PR
Practice address
Calle Nicolas Aguayo 1194
Urb El Comandante
San Juan, PR 00924-3659
Phone
(787) 644-3500
Fax
(787) 746-5433
NPI assigned
Mar 30, 2022
Last updated
Apr 13, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 817 PR Primary

Addresses

Primary practice location

Calle Nicolas Aguayo 1194
Urb El Comandante
San Juan, PR 00924-3659

Mailing address

Calle Cordova #8
Urb Terralinda
Caguas, PR 00727
Phone (787) 746-5433

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230111000245 PR Practitioner - Chiropractic 1658741509 Practice locations: San Juan, PR

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Urb El Comandante
San Juan, PR 00924
Phone (787) 644-3500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
817PRMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Life Essentials Chiropractic Center Chiropractor CurrentSince Aug 28, 2022 Accepting new patients

Locations

8 Calle Cordova
Caguas, PR 00727
Phone (787) 286-1700

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1648598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649808000000",
    "number": "1861132623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CALLE CORDOVA #8",
            "address_2": "URB TERRALINDA",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "00727",
            "telephone_number": "787-746-5433",
            "fax_number": "787-746-5433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE NICOLAS AGUAYO 1194",
            "address_2": "URB EL COMANDANTE",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009243659",
            "telephone_number": "787-644-3500",
            "fax_number": "787-746-5433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ GODOY",
        "first_name": "EDDY",
        "middle_name": "SILVANO",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-30",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PR",
            "license": "817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

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