MARIO DIAZ (P.A.) – Internal Medicine Physician, NPI 1164460697

MARIO DIAZ (P.A.) is a healthcare provider. based in Salem, Oregon. specializing in Internal Medicine Physician. They hold the professional credentials P.A.. They hold a License No. PA057229 (OR). The NPI Number for MARIO DIAZ (P.A.) is 1164460697

Main info

Male
46 Years Of Experience
Accepts Medicare Assignment
Name
MARIO DIAZ (P.A.)
NPI
1164460697
Phone
(503) 399-2424
Address
PO BOX 8100
Enumeration Date
4 June 2006
Last Update Date
18 January 2010

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5033992424
Graduation Year
1980 (46 years ago)
PAC ID
7911049564
Group Practice PAC ID
7517954514
Professional Enrollment ID
I20100121000091
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for MARIO DIAZ (P.A.)

  • Salem Post Office, 2;4, Margin Street, Downtown Salem District, Salem, Essex County, Massachusetts, 01970, United States

    SALEM, OR 973030900

    Phone: (503) 399-2424

    Fax: (503) 375-7429

    Type: Mailing

  • Salem Clinic, 2020, Capitol Street Northeast, Grant, Salem, Marion County, Oregon, 97311, United States

    SALEM, OR 973033244

    Phone: (503) 399-2424

    Fax: (503) 375-7429

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-01-21

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100121000091IPhysician AssistantORTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 97303)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7517954514View full group profile
NameSpecialtyState
Clinical Social WorkerOR
Family PracticeAZ
Family PracticeVA
Physician AssistantOR
General SurgeryOR
Physician AssistantOR
-OR
-OR
Diagnostic RadiologyOR
-OR

Reviews

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Frequently asked questions

How is MARIO DIAZ (P.A.) identified in CMS data?
CMS-hosted NPPES data lists MARIO DIAZ (P.A.) with NPI 1164460697.
Is MARIO DIAZ (P.A.) listed as active for patients and plans?
The listing shows MARIO DIAZ (P.A.) as active in the NPI system.
What healthcare role does MARIO DIAZ (P.A.) hold?
Scheduling teams often label MARIO DIAZ (P.A.) under Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
What address line appears for MARIO DIAZ (P.A.)?
MARIO DIAZ (P.A.)'s geographic hint is Salem, Oregon in our summary view.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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