NPIMap

Individual provider Active NPI

Ismael Enrique Diaz Davila, M.D.

  • General Practice Physician
  • Carolina, PR
National Provider Identifier
1972931129
Registry record updated Apr 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
18599 Issued in PR
Practice address
HX15 Calle 253
Urb Country Club 3Ra Ext
Carolina, PR 00982
Phone
(787) 630-5066
NPI assigned
Oct 25, 2013
Last updated
Apr 19, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Neomed Center, Inc. CurrentSince Dec 27, 2013 Accepting new patients
Departamento de Salud Oficial CurrentSince Sep 16, 2024 Accepting new patients
Departamento de Salud Oficial CurrentSince Sep 16, 2024 Accepting new patients
Neomed Center, Inc Current Accepting new patients
Departamento de Salud Oficial Current Accepting new patients
Neomed Center, Inc CurrentSince Dec 27, 2013 Accepting new patients
Instituto Medico del Norte Inc Past Accepting new patients
Doctors Center Hospital San Juan 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "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

Verify at the official NPI Registry.