Individual provider Active NPI

Kenneth Ortega, D.O.

  • Orthopaedic Surgery Physician
  • Utica, NY
National Provider Identifier
1083648224
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
163383-3 Issued in NY
Practice address
1903 Sunset Ave
Utica, NY 13502-5617
Phone
(315) 797-1212
Fax
(315) 797-1537
NPI assigned
Jul 11, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 163383-3 NY Primary

Addresses

Primary practice location

1903 Sunset Ave
Utica, NY 13502-5617

Mailing address

1903 Sunset Ave
Utica, NY 13502-5617
Phone (315) 797-1212

Other identifiers 1

IdentifierTypeStateIssuer
00920934MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101110000281 NY Practitioner - Orthopedic Surgery 7416923578 Reassigns benefits to 3 organizations
Practice locations: Utica, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
163383-3NYMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mak Orthopaedics PLLC Orthopaedic Surgery CurrentSince Jan 12, 2026 Accepting new patients
Mohawk Valley Orthopedicsn LLP Orthopaedic Surgery PastSince Sep 9, 2004 Accepting new patients

Locations

83 Genesee St
New Hartford, NY 13413
Phone (315) 732-0995

600 Seneca St
Oneida, NY 13421
Phone (315) 361-7472

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083648224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1903 SUNSET AVE",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135025617",
            "telephone_number": "315-797-1212",
            "fax_number": "315-797-1537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1903 SUNSET AVE",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135025617",
            "telephone_number": "315-797-1212",
            "fax_number": "315-797-1537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTEGA",
        "first_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "163383-3",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00920934",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Utica, NY

Sources for this page

Verify at the official NPI Registry.