Raul Alejandro Ortega

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

5502006101 Issued in MI

Practice address

1211 Stateline Rd
Niles, MI 49120-4729

Phone

(269) 684-2810

NPI assigned

Feb 21, 2020

Last updated

Feb 21, 2020By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1582243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582243200000",
    "number": "1225661861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10186 US HIGHWAY 31",
            "city": "BERRIEN SPRINGS",
            "state": "MI",
            "postal_code": "491039548",
            "telephone_number": "402-707-3139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 STATELINE RD",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491204729",
            "telephone_number": "269-684-2810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTEGA",
        "first_name": "RAUL",
        "middle_name": "ALEJANDRO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-21",
        "last_updated": "2020-02-21",
        "certification_date": "2020-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "5502006101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karinne Nye
• Lenser Ochieng, CRNA
• Vanessa Ann Ogle, COTA
• Shannon Marie Olsen
• Olympia Home Care, Inc
• Alexandria Lynn Osborne
• Madison Ossewaarde
• Outlaw Physical Therapy, PLLC
• Derrick Mikel Outlaw, DPT
• Karen L Palmer, MSW

• Physical Therapy Assistant in Niles, MI
• Providers in Niles, MI by specialty
• Physical Therapy Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.