Gustavo Adolfo Diaz, MD is a medicare enrolled "Otolaryngology - Facial Plastic Surgery" physician in Fairhope, Alabama. His current practice location is
411 N Section St Ste 5, Fairhope, Alabama. You can reach out to his office (for appointments etc.) via phone at
(251) 517-5050.
Gustavo Adolfo Diaz is licensed to practice in North Carolina (license number 02055) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1164599825.
Physician's Profile
| Full Name | Gustavo Adolfo Diaz |
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| Gender | Male |
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| Speciality | Otolaryngology - Facial Plastic Surgery |
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| Location | 411 N Section St Ste 5, Fairhope, Alabama |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1164599825
- Provider Enumeration Date: 11/29/2006
- Last Update Date: 08/01/2019
Medicare PECOS Information:
- PECOS PAC ID: 1759898323
- Enrollment ID: I20250729000988
Medical Identifiers
Medical identifiers for Gustavo Adolfo Diaz such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1164599825 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207YS0123X | Otolaryngology - Facial Plastic Surgery | 25353 (Alabama) | Secondary |
| 207YS0123X | Otolaryngology - Facial Plastic Surgery | ME103280 (Florida) | Secondary |
| 207YS0123X | Otolaryngology - Facial Plastic Surgery | 02055 (North Carolina) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Gustavo Adolfo Diaz allows following entities to bill medicare on his behalf.
| Entity Name | Signify Health Medical Associates PLLC |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1750845863 PECOS PAC ID: 2163764424 Enrollment ID: O20191001003503 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Gustavo Adolfo Diaz is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Gustavo Adolfo Diaz, MD 17026 Carlton Way Rd, Huntersville, NC 28078 Ph: (251) 753-2209 | Gustavo Adolfo Diaz, MD 411 N Section St Ste 5, Fairhope, AL 36532-2650 Ph: (251) 517-5050 |
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