Individual provider Active NPI

Daniel Diaz, D.O.

  • Sports Medicine (Family Medicine) Physician
  • Las Vegas, NV
National Provider Identifier
1891141446
Registry record updated Sep 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
DO2581 Issued in NV
Practice address
1524 Pinto LN FL 2
Las Vegas, NV 89106-4195
Phone
(702) 992-6888
NPI assigned
May 12, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A16032 CA
Sports Medicine (Family Medicine) Physician 207QS0010X DO2581 NV Primary

Addresses

Primary practice location

1524 Pinto LN FL 2
Las Vegas, NV 89106-4195

Mailing address

3016 W Charleston Blvd Ste 205
Las Vegas, NV 89102-1963
Phone (702) 780-2312

Other practice location 1

5420 N Figueroa St
Los Angeles, CA 90042-4118
Phone (323) 256-3884

Other identifiers 1

IdentifierTypeStateIssuer
DO2581OtherNVLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A16032CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unlv Medicine PastSince Sep 29, 2019 Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: ddiaz36578@altamed.direct-ci.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1463011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569456000000",
    "number": "1891141446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3016 W CHARLESTON BLVD STE 205",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021963",
            "telephone_number": "702-780-2312",
            "fax_number": "702-895-4014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 PINTO LN FL 2",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064195",
            "telephone_number": "702-992-6888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5420 N Figueroa St",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900424118",
            "country_code": "US",
            "telephone_number": "323-256-3884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "DANIEL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-12",
        "last_updated": "2019-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A16032",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NV",
            "license": "DO2581",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "DO2581",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.