DR. ANTONIO LUIS DIAZ MD NPI 1003016775

Internal Medicine in San Juan, PR

Individual Male Years of Experience 18 Internal Medicine PECOS Enrolled Accepts Medicare Approved Payment

About DR. ANTONIO LUIS DIAZ MD

Antonio Diaz is an internist established in San Juan, Puerto Rico and his medical specialization is Internal Medicine with more than 18 years of experience. He graduated from Ponce School Of Medicine in 2005. The NPI number of Antonio Diaz is 1003016775 and was assigned on July 2007. The practitioner's primary taxonomy code is 207R00000X with license number 26095 (PR). The provider is registered as an individual and his NPI record was last updated 12 years ago.

An internist like Dr. Antonio Luis Diaz Md is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

NPI

1003016775

Provider NameDR. ANTONIO LUIS DIAZ MD
Provider Location Address7000 CARR 844 # 844 BOX 143 SAN JUAN, PR 00926
Provider Mailing Address844 ESTANCIAS DEL BOULEVARD BOX 143 SAN JUAN, PR 00926
GenderMale
NPI Entity TypeIndividual
Medical School NamePONCE SCHOOL OF MEDICINE
Graduation Year2005
Is Sole Proprietor?Yes
Enumeration Date07-20-2007
Last Update Date05-03-2010



Antonio Diaz is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

Antonio Diaz is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data he has hospital affiliations with Hospital Pavia Santurce and Hima San Pablo Bayamon.

The typical physician office visit costs for Medicare beneficiaries in this area are: $34.07 for a new patient copayment and $26.32 for an established patient copayment.



Primary Taxonomy

Taxonomy Code207R00000X
ClassificationInternal Medicine
TypeAllopathic & Osteopathic Physicians
License No.26095
License StatePR
Taxonomy DescriptionA physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Business Address

DR. ANTONIO LUIS DIAZ MD
7000 CARR 844 # 844
BOX 143
SAN JUAN, PR
ZIP 00926
Phone: (787) 608-6304

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Mailing Address

DR. ANTONIO LUIS DIAZ MD
844 ESTANCIAS DEL BOULEVARD
BOX 143
SAN JUAN, PR
ZIP 00926
Phone: (787) 240-9909


PECOS Enrollment and Medicare Participation

What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.

Registered in PECOS? Yes
PECOS PAC ID7113050956
PECOS Enrollment IDI20100730000851
Accepts Medicare Assignment? Yes "What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

Physician Office Visit Costs

The provider accepts as payment the Medicare approved amount. Medicare beneficiaries should not be billed for more than the Medicare deductible and coinsurance amounts. Medicare pricing is usually a reference point for private insurance covered patients. The prices below reflect the costs for new and established patients in the 00926 ZIP code area.

New Patients Office Visits Costs *
Most Utilized Procedure Code for new patients office visits: 99204
Minimum New Patient Pricing Maximum New Patient Pricing Typical New Patient Pricing
$59.39 $179.95 $136.31
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$14.84 $44.98 $34.07
Established Patients Office Visits Costs *
Most Utilized Procedure Code for established patients office visits: 99214
Minimum Established Patient Pricing Maximum Established Patient Pricing Typical Established Patient Pricing
$18.52 $146.96 $105.28
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.63 $36.74 $26.32

* The physician office visit costs information is obtained by Medicare's statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Clinician Utilization

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.

  • 282Dialysis services (2-3 physician visits per month), patient 20 years of age and older (HCPCS:90961)
  • 62Dialysis services (1 physician visit per month), patient 20 years of age and older (HCPCS:90962)

Hospital Affiliations

Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Antonio Diaz is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
HOSPITAL PAVIA SANTURCECALLE PROFESOR AUGUSTO RODRIGUEZ #1462
FERNANDEZ JUNCOS, PR 910
(787) 641-1616Acute Care Hospitals400019
HIMA SAN PABLO BAYAMON70 CALLE SANTA CRUZ
BAYAMON, PR 961
(787) 620-4747Acute Care Hospitals400109

NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1003016775
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
20030112714
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 0 + 3 + 0 + 1 + 1 + 2 + 7 + 1 + 4 + 24 = 45
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 45 = 55

The NPI number 1003016775 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
Dr. Antonio Luis Diaz Md is registered as an entity type code: 1. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:

  • 1 = Person: individual human being who furnishes health care.
  • 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.