Individual provider Active NPI

Cipriana Ortega

  • Family Nurse Practitioner
  • Goshen, IN
National Provider Identifier
1083063499
Registry record updated Jun 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
28173421A Issued in IN
Practice address
400 W Lincoln Ave
Goshen, IN 46526-2413
Phone
(574) 533-7600
NPI assigned
Jun 7, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 28173421A IN Primary

Addresses

Primary practice location

400 W Lincoln Ave
Goshen, IN 46526-2413

Mailing address

400 W Lincoln Ave
Goshen, IN 46526-2413

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160701000289 IN Practitioner - Nurse Practitioner 9133411630 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maple City Health Care Center IncGroup PAC ID 2163569401, 29 clinicians

Practice addresses (Care Compare)

213 Middlebury St
Goshen, IN 46528-2956
Phone (574) 534-3300

Hospital & facility affiliations

  • Goshen Hospital Hospital, Goshen, IN, CCN 150026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28173421AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Maple City Health Care Center, Inc CurrentSince Dec 12, 2022 Accepting new patients
Maple City Health Care Center, Inc. CurrentSince Dec 12, 2022 Accepting new patients
Privia Medical Group Indiana, LLC Family Current Accepting new patients
Privia Medical Group Indiana, LLC CurrentSince Jan 1, 2020 Accepting new patients

Locations

303 S Nappanee St
Elkhart, IN 46514

808 N 3rd St
Goshen, IN 46528
Phone (574) 534-0088

2606 Peddlers Village Rd
Ste 210
Goshen, IN 46526
Phone (260) 602-3276

213 Middlebury St
Goshen, IN 46528
Phone (574) 534-0088

Organizations & group practices 4

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 1

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": "1465257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465257600000",
    "number": "1083063499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W LINCOLN AVE",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465262413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W LINCOLN AVE",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465262413",
            "telephone_number": "574-533-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTEGA",
        "first_name": "CIPRIANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-07",
        "last_updated": "2016-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28173421A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goshen, IN

Sources for this page

Verify at the official NPI Registry.