Active NPI
Raysa Ortiz, FNP
- Family Nurse Practitioner
- Bay Shore, NY
National Provider Identifier
1154058956
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 349934
- Practice address
- 1464 5TH Ave
Bay Shore, NY 11706-4147 - Phone
- (631) 231-5070
- NPI assigned
- Aug 2, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 349934 | NY | Primary |
Addresses
Primary practice location
1464 5TH Ave
Bay Shore, NY 11706-4147
Mailing address
111 Preston St
Brentwood, NY 11717-7009
Phone (631) 949-7501
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 349934 | NY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brentwood Pediatric & Adolescent Associates, PC | Past | Accepting new patients |
Interoperability endpoints
- raysa.ortiz@bpaa.eclinicaldirectplus.com
Organizations & group practices 1
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.
-
- Pediatric Adolescent Medicine Physician
- Bay Shore, NY
- NPI 1578753075
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1659398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659398400000",
"number": "1154058956",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 PRESTON ST",
"city": "BRENTWOOD",
"state": "NY",
"postal_code": "117177009",
"telephone_number": "631-949-7501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1464 5TH AVE",
"city": "BAY SHORE",
"state": "NY",
"postal_code": "117064147",
"telephone_number": "631-231-5070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ORTIZ",
"first_name": "RAYSA",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-02",
"last_updated": "2022-08-02",
"certification_date": "2022-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "349934",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bay Shore, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.