Individual provider Active NPI

Mayra Diaz

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1992320485
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149027238 Issued in IL
Practice address
2653 W Ogden Ave FL 2
Chicago, IL 60608-1647
Phone
(773) 257-6672
NPI assigned
Jun 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X 149027238 IL Primary

Addresses

Primary practice location

2653 W Ogden Ave FL 2
Chicago, IL 60608-1647

Mailing address

3539 W Le Moyne St
Chicago, IL 60651-2210
Phone (312) 912-2645

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240626003275 IL Practitioner - Clinical Social Worker 7416491824 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mount Sinai Community Foundation 247 clinicians

Practice addresses (Care Compare)

California Ave at 15TH St
Chicago, IL 60608-1858
Phone (773) 542-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Sinai Community Foundation Current Accepting new patients
Mount Sinai Community Foundation CurrentSince Sep 25, 2025 Accepting new patients
Mount Sinai Community Foundation CurrentSince Sep 25, 2025 Accepting new patients

Locations

26460 Network Pl
Chicago, IL 60673
Phone (708) 786-2900

2653 W Ogden Ave
Fl 2
Chicago, IL 60608
Phone (773) 257-5300

Interoperability endpoints

  • Direct secure messaging: mayra.diaz.1@21300.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1591747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1992320485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3539 W LE MOYNE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606512210",
            "telephone_number": "312-912-2645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2653 W OGDEN AVE FL 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081647",
            "telephone_number": "773-257-6672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "MAYRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-10",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149027238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.