Active NPI
Myrna Ortiz, P.T.
- Physical Therapist
- Newark, NJ
National Provider Identifier
1255348157
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 40QA000334600
- Practice address
- 465 Mt Prospect Ave
Newark, NJ 07104-2907 - Phone
- (973) 485-4766
- NPI assigned
- Aug 2, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 40QA000334600 | NJ | Primary |
Addresses
Primary practice location
465 Mt Prospect Ave
Newark, NJ 07104-2907
Mailing address
465 Mt Prospect Avenue
Newark, NJ 07104
Phone (973) 485-4766
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40QA000334600 | NJ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1255348157",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "465 MT PROSPECT AVENUE",
"city": "NEWARK",
"state": "NJ",
"postal_code": "07104",
"telephone_number": "973-485-4766"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "465 MT PROSPECT AVE",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071042907",
"telephone_number": "973-485-4766"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ORTIZ",
"first_name": "MYRNA",
"name_prefix": "Ms.",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA000334600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newark, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.