Individual provider Active NPI

Adolfo Dwight Diaz, MD

  • Surgery Physician
  • Laredo, TX
National Provider Identifier
1871989004
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
S4752 Issued in TX
Practice address
1710 E Saunders St Ste 460
Laredo, TX 78041-5454
Phone
(956) 796-4640
NPI assigned
Apr 14, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X S4752 TX Primary

Addresses

Primary practice location

1710 E Saunders St Ste 460
Laredo, TX 78041-5454

Mailing address

1802 E 19TH St
Kravis Building
Tulsa, OK 74104-5403

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address adolfo.diaz.1@1902.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20200511002557 TX Practitioner - General Surgery 6406169929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10700 McPherson Rd
Laredo, TX 78045-6268
Phone (956) 795-8270

108 N Robb St
Trinity, TX 75862-7602
Phone (409) 594-7632

1700 E Saunders St
Laredo, TX 78041-5474
Phone (956) 796-4738

1710 E Saunders St
Suite B460
Laredo, TX 78041-5454
Phone (956) 796-2999

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.18 of 100Reported as apm
Quality
71.02
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Hernia repair (minimally invasive)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
S4752TXMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Employee Assistance Program Inc CurrentSince Jul 1, 2020 Accepting new patients
Regional Employee Assistance Program Inc Surgery CurrentSince Jul 1, 2020 Accepting new patients
Laredo Texas Hospital Company LP Past Accepting new patients

Locations

1710 E Saunders St
Ste 460
Laredo, TX 78041
Phone (956) 796-4640

1710 E Saunders St
Ste B460
Laredo, TX 78041
Phone (956) 794-8720

1700 E Saunders St
Laredo, TX 78041
Phone (956) 206-6971

10700 McPherson Rd
Laredo, TX 78045
Phone (956) 523-2190

Interoperability endpoints

  • Direct secure messaging: adolfo.diaz.1@1902.direct.athenahealth.com

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1428969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1871989004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 E 19TH ST",
            "address_2": "KRAVIS BUILDING",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 E SAUNDERS ST STE 460",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780415454",
            "telephone_number": "956-796-4640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "ADOLFO",
        "middle_name": "DWIGHT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-14",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "S4752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adolfo.diaz.1@1902.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "1710 E Saunders St Ste 460",
            "city": "Laredo",
            "state": "TX",
            "country_code": "US",
            "postal_code": "780415454",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Laredo, TX

Sources for this page

Verify at the official NPI Registry.