Individual provider Active NPI

Jauder Diaz, NP

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1932453826
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP 9250755 Issued in FL
Practice address
75 Varick St FL 5
New York, NY 10013-1917
Phone
(855) 961-1942
NPI assigned
Oct 31, 2012
Last updated
Dec 1, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP 9250755 FL Primary

Addresses

Primary practice location

75 Varick St FL 5
New York, NY 10013-1917

Mailing address

75 Varick St FL 5
New York, NY 10013-1917
Phone (855) 961-1942

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20160603001332 FL Practitioner - Nurse Practitioner 0840413118 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP 9250755FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Valid Mde, Inc Family CurrentSince Aug 1, 2016 Accepting new patients

Locations

1695 NW 110th Ave
Ste 310
Miami, FL 33172
Phone (305) 798-5037

Interoperability endpoints

  • Direct secure messaging: jauder.diaz.1@14883.direct.athenahealth.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, 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": "1351641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1932453826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 VARICK ST FL 5",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100131917",
            "telephone_number": "855-961-1942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 VARICK ST FL 5",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100131917",
            "telephone_number": "855-961-1942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "JAUDER",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-31",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP 9250755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.