Individual provider Active NPI

Victor N. Ortiz - Justiniano, MD

  • Pediatric Surgery Physician
  • Bayamon, PR
National Provider Identifier
1275527780
Registry record updated Oct 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
4695 Issued in PR
Practice address
Puerto Rico Childrens Hospital Ofic. 302
Carr Num. 2 KM 11.7 Edif. Medical Plaza
Bayamon, PR 00960
Phone
(787) 474-5423
Fax
(787) 523-2768
NPI assigned
Sep 12, 2005
Last updated
Oct 27, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Surgery Physician 2086S0120X 4695 PR Primary

Addresses

Primary practice location

Puerto Rico Childrens Hospital Ofic. 302
Carr Num. 2 KM 11.7 Edif. Medical Plaza
Bayamon, PR 00960

Mailing address

89 Ave de Diego
PMB 646
San Juan, PR 00927-6370
Phone (787) 474-5423

Other identifiers 1

IdentifierTypeStateIssuer
2-5547OtherSSS

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4695PRMDPediatric Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Departamento de Salud Oficial Past Accepting new patients
Juan R Diaz Troche Cirujanos CSP Surgery Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319673600000",
    "number": "1275527780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 AVE DE DIEGO",
            "address_2": "PMB 646",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009276370",
            "telephone_number": "787-474-5423",
            "fax_number": "787-523-2768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PUERTO RICO CHILDRENS HOSPITAL OFIC. 302",
            "address_2": "CARR NUM. 2 KM 11.7 EDIF. MEDICAL PLAZA",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00960",
            "telephone_number": "787-474-5423",
            "fax_number": "787-523-2768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ - JUSTINIANO",
        "first_name": "VICTOR",
        "middle_name": "N.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-12",
        "last_updated": "2011-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "PR",
            "license": "4695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SSS",
            "identifier": "2-5547",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2011; 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.