Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kimberly I Diaz, PA-C

Individual provider Medical Physician Assistant · NPI 1366623639

Kimberly I Diaz, PA-C is a Physician Assistant in San Antonio, Texas. Qualified in 2004, 22 years ago. Practices with Kellum Medical Group, PA, a 4-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
22
Licensed in
TX
In the registry since
2007
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

7323 Marbach Rd Ste 104
San Antonio, TX 78227-1905
Phone: (210) 674-0257
Fax: (210) 369-9064
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA04144 (TX)

Record details

NPI number1366623639
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedNovember 15, 2007
Last updated in NPPESDecember 10, 2025
Certification dateDecember 10, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Kellum Medical Group, Pa — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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