Active NPI
Naticia Mortensen
- Family Medicine Physician
- Lubbock, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- S8615
- Practice address
- 5915 82ND St
Lubbock, TX 79424-3673 - Phone
- (806) 794-3000
- Fax
- (806) 698-0847
- NPI assigned
- Jun 12, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | S8615 | TX | Primary |
Addresses
Primary practice location
5915 82ND St
Lubbock, TX 79424-3673
Mailing address
2215 Nashville Ave
Lubbock, TX 79410-1105
Phone (806) 725-5844
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Texas Tech University Health Science Center School of Medicine, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2215 Nashville Ave
Lubbock, TX 79410-1105
Phone (806) 725-5844
306 W 3Rd St
Big Spring, TX 79720-2429
Phone (432) 267-3806
Hospital & facility affiliations
- Excelacare Home Health
- Calvert Home Health Care, LLC
- Direct Health Care Inc
- Covenant Medical Center
- Covenant Childrens Hospital
- Grace Surgical Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S8615 | TX | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Covenant Medical Group | Family Medicine | Current | Accepting new patients |
| Covenant Medical Group | Family Medicine | Current | Accepting new patients |
Locations
3601 4th St
Stop 8143
Lubbock, TX 79430
Phone (806) 743-2757
5915 82nd St
Lubbock, TX 79424
Phone (806) 794-3000
2215 Nashville Ave
Lubbock, TX 79410
Phone (806) 725-5228
Interoperability endpoints
- nmortensen1929912@oc.providencedirect.org
Ownership & related parties
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Direct Healthcare, Inc. | Hospice | W-2 Managing Employee (5%) | Dec 15, 2022 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Community Based Hospice Care Agency
- Lubbock, TX
- NPI 1962709998
W-2 Managing Employee
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Lubbock, TX
- NPI 1376598904
-
- Rehabilitation Clinic/Center
- Big Spring, TX
- NPI 1760486708
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Lubbock, TX
- NPI 1801866306
-
- General Acute Care Hospital
- Lubbock, TX
- NPI 1972517365
-
- Community Based Hospice Care Agency
- Lubbock, TX
- NPI 1962709998
-
- Home Health Agency
- Lubbock, TX
- NPI 1710927983
-
- General Acute Care Hospital
- Lubbock, TX
- NPI 1225289499
-
- Children's Hospital
- Lubbock, TX
- NPI 1437171568
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682553600000",
"number": "1033602115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2215 NASHVILLE AVE",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794101105",
"telephone_number": "806-725-5844",
"fax_number": "806-723-6532"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5915 82ND ST",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794243673",
"telephone_number": "806-794-3000",
"fax_number": "806-698-0847"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORTENSEN",
"first_name": "NATICIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-12",
"last_updated": "2023-04-27",
"certification_date": "2023-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "S8615",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lubbock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.