Gerardo Diaz, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

71006047A Issued in IN

Practice address

808 N 3Rd St
Goshen, IN 46528

Phone

(574) 534-0088

Fax

(574) 971-8434

NPI assigned

Feb 8, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Indiana University School of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Maple City Health Care Center IncGroup PAC ID 2163569401, 29 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gdiaz299535@direct.ochin.org

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.

• Maple City Health Care Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Goshen, IN
  • NPI 1033166095
  Medicare reassignment Care Compare group NPD
• Maple City Health Care Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Goshen, IN
  • NPI 1275220303
  NPD
• Maple City Health Care Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Goshen, IN
  • NPI 1891181517
  NPD

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

{
    "created_epoch": "1454889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615248000000",
    "number": "1861850695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 N 3RD ST",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465287100",
            "telephone_number": "574-534-0088",
            "fax_number": "574-971-8434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 N 3RD ST",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "46528",
            "telephone_number": "574-534-0088",
            "fax_number": "574-971-8434"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "213 Middlebury St",
            "address_purpose": "LOCATION",
            "city": "Goshen",
            "state": "IN",
            "postal_code": "465282956",
            "country_code": "US",
            "telephone_number": "574-534-3300",
            "fax_number": "574-534-5412",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "GERARDO",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-08",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71006047A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gdiaz299535@direct.ochin.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "808 N 3rd St",
            "city": "Goshen",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46528",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Aaron Blaine Detwiler, MSW, LCSW
• Jamie Marie Detwiler, FNP-BC
• John Hanlan Deuschle, D.D.S.
• Nathaniel T Dew, MD
• Elizabeth Diaz, RN
• Shirley Dick, LCSW
• Jennifer Erin Dickey, MSN, PMHNP-BC
• Daniel A Diener, MD
• Eckhart Diestel, MD
• Djo, LLC

• Nurse Practitioner in Goshen, IN
• Providers in Goshen, IN by specialty
• Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2021; 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.