Active NPI
Ismael Enrique Diaz Davila, M.D.
- General Practice Physician
- Carolina, PR
National Provider Identifier
1972931129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 18599
- Practice address
- HX15 Calle 253
Urb Country Club 3Ra Ext
Carolina, PR 00982 - Phone
- (787) 630-5066
- NPI assigned
- Oct 25, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 18599 | PR | Primary |
Addresses
Primary practice location
HX15 Calle 253
Urb Country Club 3Ra Ext
Carolina, PR 00982
Mailing address
HX15 Calle 253
Urb Country Club 3Ra Ext
Carolina, PR 00982
Phone (787) 630-5066
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140127000415 | PR | Practitioner - General Practice | 2163651969 |
Reassigns benefits to 2 organizations Practice locations: Carolina, PR |
Care Compare profile
Medicare Care Compare- Specialty
- General Practice
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
Calle Fernandez Juncos
Edificio Jesus T Pinero
Carolina, PR 00985
Phone (787) 630-5066
Hospital & facility affiliations
- Hospital San Francisco
- Centro Medico del Noreste
- Doctors' Center Hospital San Juan
- Centro Medico Wilma N Vazquez
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Departamento de Salud Oficial | Current | Accepting new patients | |
| Departamento de Salud Oficial | Current | Accepting new patients | |
| Neomed Center, Inc | Current | Accepting new patients | |
| Neomed Center, Inc | Current | Accepting new patients | |
| Neomed Center, Inc. | Current | Accepting new patients | |
| Departamento de Salud Oficial | Current | Accepting new patients | |
| Doctors Center Hospital San Juan | Past | Accepting new patients | |
| Instituto Medico del Norte Inc | Past | Accepting new patients |
Organizations & group practices 8
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.
-
- Emergency Care Clinic/Center
- Adjuntas, PR
- NPI 1184827370
-
- Health Service Clinic/Center
- Mayaguez, PR
- NPI 1215061148
-
- Clinical Medical Laboratory
- Gurabo, PR
- NPI 1518286962
-
- Federally Qualified Health Center (FQHC)
- Naguabo, PR
- NPI 1093357337
-
- General Acute Care Hospital
- San Juan, PR
- NPI 1699748236
-
- Skilled Nursing Facility
- Vega Baja, PR
- NPI 1386672830
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
- San Juan, PR
- NPI 1205539558
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1382659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492560000000",
"number": "1972931129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "HX15 CALLE 253",
"address_2": "URB COUNTRY CLUB 3RA EXT",
"city": "CAROLINA",
"state": "PR",
"postal_code": "00982",
"telephone_number": "787-630-5066"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "HX15 CALLE 253",
"address_2": "URB COUNTRY CLUB 3RA EXT",
"city": "CAROLINA",
"state": "PR",
"postal_code": "00982",
"telephone_number": "787-630-5066"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAZ DAVILA",
"first_name": "ISMAEL",
"middle_name": "ENRIQUE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-10-25",
"last_updated": "2017-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "PR",
"license": "18599",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carolina, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2017; 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.