JOSE A DIAZ M.D.
NPI 1982693271
Surgery in Highland, IL

Q: What is Jose Diaz's NPI number?

The NPI number for Jose Diaz is 1982693271. It was assigned to this individual provider in the NPPES registry on October 19, 2005.

Q: What is Jose Diaz's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Q: When was this NPI record last updated?

The NPPES record for Jose Diaz was last updated on November 8, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 19, 2005PECOS EnrolledAccepts Medicare Assignment

94.61/100

CMS Quality Rating

12860 TROXLER AVE, HIGHLAND, IL 62249(618) 664-9831 Get Directions Write a Review

NPPES record last updated: November 8, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Nov 8, 2022, Dec 29, 2021 (2 updates tracked since 2021).

On this page

About Jose A Diaz M.d. NPPES

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

JOSE A DIAZ M.D. (NPI 1982693271) is an individual surgery provider in Highland, Illinois, licensed in Illinois (036.077861) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS, is affiliated with Hshs Holy Family Hospital Inc, and is a graduate of University Of Missouri, Columbia School Of Medicine (1982).

NPPES Registry Identity

NPI1982693271

Entity TypeIndividualMale

Primary Taxonomy208600000X

Provider Legal NameJOSE A DIAZCredential: M.D.

Location Address12860 TROXLER AVEHighland, IL 62249-2898

Mailing Address12860 Troxler AveHighland, IL 62249-2898 · (618) 664-9831

Phone(618) 664-9831

Sole ProprietorNo

Medical School CMSUniversity Of Missouri, Columbia School Of MedicineGraduated 1982

Enumeration DateOctober 19, 2005

Last NPPES UpdateNovember 8, 20222 updates tracked since enumeration

NPPES CertifiedNovember 8, 2022

✔ NPI 1982693271 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208600000X

License✔ Licensed in IL · 036.077861

Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

12860 TROXLER AVE, Highland, IL 62249

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Other Identifiers 1

Medicaid036077861IL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware, Medica.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jose A Diaz M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5395710941

PECOS Enrollment IDI20080303000361

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.

Medicare Billing Reassignments

Medicare enrollment records show Jose Diaz reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

St Josephs Hospital Of The Hospital Sisters Of The Third Order Of St F

Same address

Critical Access

12866 TROXLER AVE
Highland, IL 62249

Reassigned Medicare billing, Illinois enrollment
48 clinicians in this Medicare group

NPI 1447352323 (618) 654-7421

Hshs Holy Family Hospital Inc

17 mi

Obstetrics & Gynecology

150 HEALTHCARE DRIVE
Greenville, IL 62246

Reassigned Medicare billing, Illinois enrollment
42 clinicians in this Medicare group

NPI 1992889125 (618) 664-9830

Sjl Health Systems Inc

53 mi

Skilled Nursing Facility

900 S CHESTNUT ST
Pana, IL 62557

Reassigned Medicare billing, Illinois enrollment
Medicare enrollment name: Hshs Medical Group Inc
317 clinicians in this Medicare group

NPI 1215037353 (217) 562-3996

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 13

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Removal of skin and tissue, 20.0 sq cm or less 11042

This procedure involves the surgical removal of skin and tissue, up to 20.0 square cm in size. It's often performed to treat conditions like skin cancer or to remove moles, warts, and other skin lesions. The area is numbed and the unwanted tissue is carefully cut out.

514 services80 patients

Removal of tissue from wound, 20.0 sq cm or less 97597

This procedure involves the careful removal of damaged or infected tissue from a wound that's 20.0 square cm or less. It's done to promote healing and prevent further infection. The process is carried out under local anesthesia, ensuring minimal discomfort.

318 services80 patients

Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less 15271

This procedure involves applying a skin substitute graft to a wound on the trunk, arms, or legs. The graft, a lab-grown skin, is used to cover a wound area of 25.0 sq cm or less, within a total wound area of 100.0 sq cm or less. It aids in healing and regeneration.

131 services19 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

96 services58 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

76 services50 patients

Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 25.0 sq cm or less of wound 100.0 sq cm or less 15275

This procedure involves applying a skin substitute graft to a wound that's 25.0 sq cm or less, located on areas such as the face, scalp, eyelids, mouth, neck, ears, around eyes, hands, feet, fingers, or toes. The graft aids in wound healing and tissue regeneration.

70 services14 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

33 services33 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

25 services18 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

23 services23 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

16 services11 patients

Removal of muscle and/or tissue, 20.0 sq cm or less 11043

This procedure involves the surgical removal of a specified area (20.0 sq cm or less) of muscle and/or tissue. It's typically done to treat conditions like tumors, infections, or injuries. Local or general anesthesia ensures comfort. Recovery time varies.

15 services11 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

12 services11 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

11 services11 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Hshs Holy Family Hospital Inc

Acute Care Hospitals · Greenville, IL

OwnershipVoluntary non-profit - Church

CMS Certification Number140137

Location200 Health Care DrGreenville, IL 62246 · Bond County

Emergency services

St Josephs Hospital

Acute Care Hospitals · Breese, IL

OwnershipVoluntary non-profit - Church

CMS Certification Number140145

Location9515 Holy Cross LnBreese, IL 62230 · Clinton County

Emergency services Birthing friendly

Hshs St Elizabeth's Hospital

Acute Care Hospitals · O Fallon, IL

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number140187

LocationOne St Elizabeth BoulevardO Fallon, IL 62269 · St. Clair County

Emergency services Birthing friendly

St Joseph's Hospital

Critical Access Hospitals · Highland, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number141336

Location12866 Troxler AvenueHighland, IL 62249 · Madison County

Emergency services

Ssm Health Saint Louis University Hospital

Acute Care Hospitals · Saint Louis, MO

1/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number260105

Location3635 Vista AveSaint Louis, MO 63110 · St. Louis City County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62249 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

$88.44 typical visit price

range $56.28 – $173.35

Typical copayment $22.11 (range $14.07 – $43.33)

Most-billed visit code 99203

Established Patient

$70.42 typical visit price

range $17.51 – $139.99

Typical copayment $17.60 (range $4.37 – $34.99)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

94.61/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

85.17

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Collagen dressing, sterile, size 16 sq. in. or less, each A6021

DME-Medical/Surgical Supplies · category DA023N

2 suppliers20 claims641 services$20.30 avg. paid by Medicare

Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard A6446

DME-Medical/Surgical Supplies · category DA023N

2 suppliers15 claims1,255 services$0.38 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

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

MRS. RACHEL C. GIFFHORN PMHNP-BC

Nurse Practitioner