Active NPI
Trystan Noel Ortega
- Behavior Analyst
- Pueblo, CO
National Provider Identifier
1063087450
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- RBT-21-150639
- Practice address
- 401 Broadway Ave
Pueblo, CO 81004-2127 - Phone
- (719) 329-4208
- NPI assigned
- May 26, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | RBT-21-150639 | CO | Primary |
Addresses
Primary practice location
401 Broadway Ave
Pueblo, CO 81004-2127
Mailing address
425 W Lookout Dr
Pueblo West, CO 81007-3677
Phone (719) 329-4208
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-21-150639 | CO | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621987200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621987200000",
"number": "1063087450",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "425 W LOOKOUT DR",
"city": "PUEBLO WEST",
"state": "CO",
"postal_code": "810073677",
"telephone_number": "719-329-4208"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 BROADWAY AVE",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810042127",
"telephone_number": "719-329-4208"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ORTEGA",
"first_name": "TRYSTAN",
"middle_name": "NOEL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-05-26",
"last_updated": "2021-05-26",
"certification_date": "2021-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CO",
"license": "RBT-21-150639",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pueblo, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.