Emilio Cardona-Ortiz, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301064038 Issued in MI

Practice address

10248 W Jefferson Ave
River Rouge, MI 48218-1321

Phone

(313) 841-7575

Fax

(313) 841-1713

NPI assigned

Aug 19, 2005

Last updated

May 29, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401321600000",
    "number": "1265424816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27774 FRANKLIN RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480342352",
            "telephone_number": "248-356-5555",
            "fax_number": "248-356-5544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10248 W JEFFERSON AVE",
            "city": "RIVER ROUGE",
            "state": "MI",
            "postal_code": "482181321",
            "telephone_number": "313-841-7575",
            "fax_number": "313-841-1713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDONA-ORTIZ",
        "first_name": "EMILIO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2014-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301064038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3477807-10",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Russell Barna, DPM
• Latisha Blackwell
• Brightsmiles
• Colleen Marie Bryant, NP
• Quanesia Campbell
• City of River Rouge Fire Dept
• Delecia O Clark
• CLW Adult Day Care Service LLC
• Charlotte Davis Coates
• Detroit Second Chance Inc

• Family Medicine Physician in River Rouge, MI
• Providers in River Rouge, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2014; 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.