NPIMap

Organization Active NPI

Gabriela Ortiz-Omphroy MD LLC

  • Family Medicine Physician
  • Aiea, HI
National Provider Identifier
1285994525
Registry record updated Aug 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
12351 Issued in HI
Legal business name
GABRIELA ORTIZ-OMPHROY MD LLC
Practice address
98-1079 Moanalua Rd Ste 680
Aiea, HI 96701-4725
Phone
(808) 488-4342
Fax
(808) 488-4151
NPI assigned
May 21, 2012
Last updated
Aug 30, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2012

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

Authorized official

Name
Dr. Gabriela M Ortiz-Omphroy, M.D.NPI 1093879884
Title
Owner
Phone
(808) 488-4342

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 12351 HI Primary

Addresses

Primary practice location

98-1079 Moanalua Rd Ste 680
Aiea, HI 96701-4725

Mailing address

98-1079 Moanalua Rd Ste 680
Aiea, HI 96701-4725
Phone (808) 488-4342

Other identifiers 1

IdentifierTypeStateIssuer
53927313MedicaidHI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120824000472 HI Part B Supplier - Clinic/Group Practice 5991952012 Receives reassigned benefits from 3 practitioners
Practice locations: Aiea, HI

National Provider Directory

National Provider Directory
Tax ID family
Gabriela Ortiz-Omphroy MD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1337558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346284800000",
    "number": "1285994525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98-1079 MOANALUA RD STE 680",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967014725",
            "telephone_number": "808-488-4342",
            "fax_number": "808-488-4151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98-1079 MOANALUA RD STE 680",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967014725",
            "telephone_number": "808-488-4342",
            "fax_number": "808-488-4151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GABRIELA ORTIZ-OMPHROY MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-21",
        "last_updated": "2012-08-30",
        "status": "A",
        "authorized_official_last_name": "ORTIZ-OMPHROY",
        "authorized_official_first_name": "GABRIELA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-488-4342",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "12351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "53927313",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiea, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.