Individual provider Active NPI

Ian Diaz

  • Certified Registered Nurse Anesthetist
  • Hollywood, FL
National Provider Identifier
1982374120
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
11024169 Issued in FL
Practice address
3501 Johnson St
Hollywood, FL 33021-5421
Phone
(954) 987-2000
NPI assigned
Sep 19, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

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 ProgramGroup: 193400000X SINGLE SPECIALTY GROUP 390200000X
Certified Registered Nurse Anesthetist 367500000X 11024169 FL Primary

Addresses

Primary practice location

3501 Johnson St
Hollywood, FL 33021-5421

Mailing address

11200 SW 8TH St # 3-342
Miami, FL 33199-2516
Phone (305) 348-7747

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230418000277 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 7618342098 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Miami Beach Anesthesiology Associates IncGroup PAC ID 6103713243, 61 clinicians

Practice addresses (Care Compare)

4300 Alton Rd
Miami, FL 33140-2948
Phone (305) 674-2121

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11024169FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiology Professional Services, Inc. Single Specialty CurrentSince Mar 27, 2023 Accepting new patients
Miami Beach Anesthesiology Associates Inc Single Specialty CurrentSince Jun 15, 2024 Accepting new patients

Locations

460 Saint Charles Ct
Lake Mary, FL 32746
Phone (407) 585-0260

4300 Alton Rd
Miami Beach, FL 33140
Phone (305) 481-9776

Organizations & group practices 2

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": "1632009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1982374120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11200 SW 8TH ST # 3-342",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331992516",
            "telephone_number": "305-348-7747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 JOHNSON ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215421",
            "telephone_number": "954-987-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "IAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-19",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "11024169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.