MR. KIMI SAN MIGUEL DIAZ MS, PA-C
NPI 1114632510
Physician Assistant in Peabody, MA

Q: What is Kimi San Miguel Diaz's NPI number?

The NPI number for Kimi San Miguel Diaz is 1114632510. It was assigned to this individual provider in the NPPES registry on January 19, 2023.

Q: What is Kimi San Miguel Diaz's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Active since January 19, 2023PECOS Enrolled

300 JUBILEE DR, PEABODY, MA 01960(978) 513-7588 Get Directions Write a Review

NPPES record last updated: October 23, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 23, 2023, Jan 19, 2023 (2 updates tracked since 2023).

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About Mr. Kimi San Miguel Diaz Ms, Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. KIMI SAN MIGUEL DIAZ MS, PA-C (NPI 1114632510) is an individual physician assistant in Peabody, Massachusetts and active in the NPI registry since January 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1114632510

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameMR. KIMI SAN MIGUEL DIAZCredential: MS, PA-C

Location Address300 JUBILEE DRPeabody, MA 01960-4068

Mailing AddressPo Box 163Mongaup Valley, NY 12762-0163

Phone(978) 513-7588

Sole ProprietorNo

Enumeration DateJanuary 19, 2023

Last NPPES UpdateOctober 23, 20232 updates tracked since enumeration

NPPES CertifiedOctober 23, 2023

✔ NPI 1114632510 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

300 JUBILEE DR, Peabody, MA 01960

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Kimi San Miguel Diaz Ms, Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 01960 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$90.70 typical visit price

range $58.86 – $177.36

Typical copayment $22.67 (range $14.71 – $44.34)

Most-billed visit code 99203

Established Patient

$73.22 typical visit price

range $19.11 – $144.84

Typical copayment $18.30 (range $4.77 – $36.21)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EVELYN MARIE DREYER ARNP

Nurse Practitioner (Family)