NPIMap

Individual provider Active NPI

Jose A Diaz, M.D.

  • Surgery Physician
  • Highland, IL
National Provider Identifier
1982693271
Registry record updated Nov 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
036.077861 Issued in IL
Practice address
12860 Troxler Ave
Highland, IL 62249-2898
Phone
(618) 664-9831
NPI assigned
Oct 19, 2005
Last updated
Nov 8, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 036.077861 IL Primary

Addresses

Primary practice location

12860 Troxler Ave
Highland, IL 62249-2898

Mailing address

12860 Troxler Ave
Highland, IL 62249-2898
Phone (618) 664-9831

Other identifiers 1

IdentifierTypeStateIssuer
036077861MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jdiaz104991@ewd.direct.hshs.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20080303000361 IL Practitioner - General Surgery 5395710941 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Missouri, Columbia School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HSHS Medical Group IncGroup PAC ID 5092857821, 212 clinicians

Practice addresses (Care Compare)

1512 N Green Mount Rd
Suite 108
Ofallon, IL 62269-1953
Phone (618) 624-5510

1900 E Lake Shore Dr
Suite 330
Decatur, IL 62521-3848
Phone (217) 423-2889

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue720
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.077861ILMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
HSHS Medical Group Inc CurrentSince Jul 1, 2010 Accepting new patients
HSHS Holy Family Hospital Inc CurrentSince Jul 1, 2013 Accepting new patients
HSHS Holy Family Hospital Inc CurrentSince Jul 1, 2013 Accepting new patients
St Josephs Hospital of the Hospital Sisters of the Third Order of St F CurrentSince May 3, 2010 Accepting new patients
St Josephs Hospital of the Hospital Sisters of the Third Order of St F CurrentSince May 3, 2010 Accepting new patients
HSHS Medical Group Inc CurrentSince Jul 1, 2010 Accepting new patients
Excel Care Orthopedics, Inc. Past Accepting new patients
HSHS Medical Group Inc Past Accepting new patients

Locations

1900 E Lake Shore Dr
Ste 330
Decatur, IL 62521
Phone (217) 423-2889

200 Health Care Dr
Greenville, IL 62246
Phone (618) 664-0808

12860 Troxler Ave
Highland, IL 62249
Phone (618) 235-3687

12860 Troxler Ave
Ste 120
Highland, IL 62249
Phone (618) 664-9831

12866 Troxler Ave
Highland, IL 62249
Phone (618) 651-2600

1512 N Green Mount Rd
O Fallon, IL 62269
Phone (618) 624-0100

3051 Hollis Dr
Fl 2
Springfield, IL 62704
Phone (217) 321-9321

Interoperability endpoints

  • Direct secure messaging: jdiaz104991@ewd.direct.hshs.org

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 7

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": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1982693271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12860 TROXLER AVE",
            "city": "HIGHLAND",
            "state": "IL",
            "postal_code": "622492898",
            "telephone_number": "618-664-9831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12860 TROXLER AVE",
            "city": "HIGHLAND",
            "state": "IL",
            "postal_code": "622492898",
            "telephone_number": "618-664-9831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "JOSE",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-19",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036.077861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036077861",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jdiaz104991@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "12860 Troxler Ave",
            "city": "Highland",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622492898",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Highland, IL

Sources for this page

Verify at the official NPI Registry.