NPIMap

Individual provider Active NPI

Luis E. Ortiz, M.D.

  • Emergency Medicine Physician
  • Brockton, MA
National Provider Identifier
1063447415
Registry record updated Sep 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
78720 Issued in MA
Practice address
680 Centre St
Brockton, MA 02302-3308
Phone
(508) 941-7000
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 78720 MA Primary

Addresses

Primary practice location

680 Centre St
Brockton, MA 02302-3308

Mailing address

680 Centre St
Brockton, MA 02302-3308
Phone (508) 941-7000

Other identifiers 1

IdentifierTypeStateIssuer
1200283MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040928000480 MA Practitioner - Emergency Medicine 5395723613 Reassigns benefits to 3 organizations
I20200710002453 TX Practitioner - Emergency Medicine 5395723613 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Round Table Physicians Group PLLCGroup PAC ID 0547682460, 80 clinicians

Practice addresses (Care Compare)

8910 Hwy 6 S
Houston, TX 77083-6339
Phone (832) 699-3777

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
78720MAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southcoast Hospitals Group Inc CurrentSince Feb 11, 2009 Accepting new patients
Round Table Physicians Group PLLC CurrentSince Mar 1, 2020 Accepting new patients
Southcoast Hospitals Group, Inc Current Accepting new patients
Steward Emergency Physicians, Inc Emergency Medicine CurrentSince Dec 31, 2012 Accepting new patients
Southcoast Hospitals Group, Inc CurrentSince Feb 11, 2009 Accepting new patients
Round Table Specialist Group, PLLC Emergency Medicine Current Accepting new patients
Steward Medical Group, Inc PastSince Oct 1, 2014 Accepting new patients
Osprey Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Florida Em-I Medical Services PA Emergency Medicine Past Accepting new patients
Bridgewater Goddard Park Medical Associates, Inc. Past Accepting new patients

Locations

200 Groton Rd
Ayer, MA 01432
Phone (978) 784-9000

363 Highland Ave
Fall River, MA 02720
Phone (508) 679-7052

70 East St
Methuen, MA 01844
Phone (978) 682-1906

874 Purchase St
New Bedford, MA 02740
Phone (508) 992-6553

88 Washington St
Taunton, MA 02780
Phone (508) 828-7000

5701 W Slaughter Ln
Bldg G
Austin, TX 78749
Phone (512) 651-5787

1014 Wirt Rd
Ste 200
Houston, TX 77055
Phone (713) 527-5000

8910 Highway 6 S
Houston, TX 77083
Phone (281) 258-4351

11103 Westheimer Rd
Houston, TX 77042
Phone (832) 708-3651

800 W Central Texas Expy
Killeen, TX 76541
Phone (254) 220-4117

Organizations & group practices 11

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537315200000",
    "number": "1063447415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 CENTRE ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023023308",
            "telephone_number": "508-941-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 CENTRE ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023023308",
            "telephone_number": "508-941-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ",
        "first_name": "LUIS",
        "middle_name": "E.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2018-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "78720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1200283",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.