Luis Antonio Ortiz Heredia

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

16621 Issued in PR

Practice address

Caribbean Medical Center Ponce by Pass 2275
Suite 202
Ponce, PR 00717-0020

Phone

(787) 840-1455

Fax

(787) 848-4657

NPI assigned

Jun 25, 2007

Last updated

Jul 15, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

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

Specialty

General Practice

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeast Renal Group PSCGroup PAC ID 0840517025, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• FMC Of Juana Diaz Dialysis facility, Juana Diaz, PR, CCN 402554
• Hospital Episcopal San Lucas II Hospital, Ponce, PR, CCN 400044

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Southeast Renal Group PSC

  • Nephrology Physician
  • Santa Isabel, PR
  • NPI 1821413527
  Medicare reassignment Care Compare group NPD Authorized official
• South Renal Care, P.S.C

  • Nephrology Physician
  • Ponce, PR
  • NPI 1295020790
  Medicare reassignment NPD Authorized official

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

• Saint Lukes Memorial Hospital Inc

  dba Hospital San Lucas

  • General Acute Care Hospital
  • Ponce, PR
  • NPI 1841295557
  Care Compare affiliation

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310688000000",
    "number": "1083810162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 335251",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007335251",
            "telephone_number": "787-362-0722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARIBBEAN MEDICAL CENTER PONCE BY PASS 2275",
            "address_2": "SUITE 202",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007170020",
            "telephone_number": "787-840-1455",
            "fax_number": "787-848-4657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ HEREDIA",
        "first_name": "LUIS",
        "middle_name": "ANTONIO",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-25",
        "last_updated": "2011-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "PR",
            "license": "16621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nelson Joel Ortiz Castillo
• Maricelys Ortiz Castro
• Alberto Romulo Ortiz Corrada, MD
• Paola Nycole Ortiz Cotto
• Indira Ortiz Gandia
• Ivan Jose Ortiz Laboy, MEDICINE STUDENT
• Elmer Luis Ortiz Marquez
• Maria Isabel Ortiz Mattei
• Ines Ortiz Medina, TRABAJADOR SOCIAL
• Jennifer Ortiz Melendez, O.D.

• Nephrology Physician in Ponce, PR
• Providers in Ponce, PR by specialty
• Nephrology Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; 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.

Verify at the official NPI Registry.