Individual provider Active NPI

Luis D Ortega, PA-C

  • Surgical Physician Assistant
  • Yakima, WA
National Provider Identifier
1215363833
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA60325052 Issued in WA
Practice address
4001 Tieton Dr
Yakima, WA 98908-3345
Phone
(509) 410-0746
Fax
(509) 410-0749
NPI assigned
Sep 16, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA60325052 WA Primary

Addresses

Primary practice location

4001 Tieton Dr
Yakima, WA 98908-3345

Mailing address

1211 N 16TH Ave
Yakima, WA 98902-1347
Phone (509) 454-8888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20131018000496 WA Practitioner - Physician Assistant 3870727241 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summitview Urgent Care IncGroup PAC ID 7911316526, 8 clinicians
Physicians Immediate Care and Medical Centers PSGroup PAC ID 7618865775, 19 clinicians

Practice addresses (Care Compare)

120 S 72ND Ave
Suite 102
Yakima, WA 98908-4200
Phone (509) 902-8856

1225 SE Commercial Dr
College Place, WA 99324-9721
Phone (509) 516-1101

1516 Jadwin Ave
Richland, WA 99354-2902
Phone (509) 946-1695

4001 Tieton Dr
Yakima, WA 98908-3345
Phone (509) 410-0746

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA60325052WAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Healthcare and Wellness Center, PLLC Past Accepting new patients
Icco, LLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1379289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1215363833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 N 16TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989021347",
            "telephone_number": "509-454-8888",
            "fax_number": "509-453-0061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 TIETON DR",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989083345",
            "telephone_number": "509-410-0746",
            "fax_number": "509-410-0749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTEGA",
        "first_name": "LUIS",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-16",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA60325052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.