Individual provider Active NPI

Johanny Ortiz

  • Psychiatric/Mental Health Nurse Practitioner
  • Naples, FL
National Provider Identifier
1154027746
Registry record updated Dec 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11024151 Issued in FL
Practice address
4949 Tamiami TRL N Ste 202
Naples, FL 34103-3017
Phone
(239) 259-1659
Fax
(239) 692-8264
NPI assigned
Feb 6, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11024151 FL Primary

Addresses

Primary practice location

4949 Tamiami TRL N Ste 202
Naples, FL 34103-3017

Mailing address

4949 Tamiami TRL N Ste 202
Naples, FL 34103-3017
Phone (239) 591-6592

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20230421001109 FL Practitioner - Nurse Practitioner 9638534829 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Grow Healthcare Group PAGroup PAC ID 3476961368, 1,045 clinicians

Practice addresses (Care Compare)

4949 Tamiami TRL N
Suite 202
Naples, FL 34103-3017
Phone (239) 259-1659

66 E Flagler St
Miami, FL 33130-1807
Phone (786) 244-7711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11024151FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mindful Health Organization Inc. CurrentSince Mar 1, 2023 Accepting new patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Jan 21, 2025 Accepting new patients
Phoenix Behavioral Group LLC Psychiatric/Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

4949 Tamiami Trl N
Ste 202
Naples, FL 34103
Phone (239) 259-1659

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1675641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701993600000",
    "number": "1154027746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4949 TAMIAMI TRL N STE 202",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341033017",
            "telephone_number": "239-591-6592",
            "fax_number": "239-692-8264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4949 TAMIAMI TRL N STE 202",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341033017",
            "telephone_number": "239-259-1659",
            "fax_number": "239-692-8264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ",
        "first_name": "JOHANNY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-06",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11024151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

Verify at the official NPI Registry.