Individual provider Active NPI

Eduardo Ortiz Hormaza, MD

  • Diagnostic Radiology Physician
  • New York, NY
National Provider Identifier
1275262909
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
315187 Issued in NY
Practice address
1275 York Ave
New York, NY 10065-6007
Phone
(212) 639-3572
Fax
(212) 794-4010
NPI assigned
Jun 8, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 315187 NY Primary

Addresses

Primary practice location

1275 York Ave
New York, NY 10065-6007

Mailing address

1275 York Ave
New York, NY 10065-6007
Phone (212) 639-2000

Other names 1

  • Dr. Eduardo Ortiz Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221116002972 NY Practitioner - Diagnostic Radiology 7719355080 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mskcc Radiology GroupGroup PAC ID 3971494683, 192 clinicians

Practice addresses (Care Compare)

1275 York Ave
New York, NY 10065-6007
Phone (212) 639-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
315187NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mskcc Radiology Group Diagnostic Radiology CurrentSince Aug 3, 2022 Accepting new patients

Locations

633 3rd Ave
Fl 4
New York, NY 10017
Phone (646) 227-3764

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1654646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1275262909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656007",
            "telephone_number": "212-639-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656007",
            "telephone_number": "212-639-3572",
            "fax_number": "212-794-4010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ HORMAZA",
        "first_name": "EDUARDO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-08",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "315187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EDUARDO",
            "last_name": "ORTIZ",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.