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

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1093475246

Mario Antonio Diaz, PA-C is a Physician Assistant in Patchogue, New York. Qualified in 2021, 5 years ago. Practices with St Joseph Hospital, a 99-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
5
Licensed in
NY
In the registry since
2021
Specialties on file
2
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

101 Hospital Rd
Patchogue, NY 11772-4870
Phone: (631) 575-9591
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 027841 (NY)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1093475246
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedDecember 28, 2021
Last updated in NPPESJanuary 17, 2022
Certification dateJanuary 13, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice St. Joseph Hospital — 99 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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