Active NPI
Kyle Jared Ortiz Rodriguez
- Student in an Organized Health Care Education/Training Program
- Indianapolis, IN
National Provider Identifier
1114481983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 355 W 16TH St # Gh5100
Indianapolis, IN 46202-2207 - Phone
- (317) 963-8145
- NPI assigned
- Jan 25, 2019
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
355 W 16TH St # Gh5100
Indianapolis, IN 46202-2207
Mailing address
HC-2 Box 2267
Boqueron, PR 00622
Phone (787) 538-2750
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210721002952 | IN | Order and Referring Only - Neurosurgery | 1557764073 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623628800000",
"number": "1114481983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "HC-2 BOX 2267",
"city": "BOQUERON",
"state": "PR",
"postal_code": "00622",
"telephone_number": "787-538-2750"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "355 W 16TH ST # GH5100",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462022207",
"telephone_number": "317-963-8145"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ORTIZ RODRIGUEZ",
"first_name": "KYLE",
"middle_name": "JARED",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-01-25",
"last_updated": "2021-06-14",
"certification_date": "2021-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.