Carlos Ortega MD SC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

036100042 Issued in IL

Legal business name

CARLOS ORTEGA MD SC

Doing business as

Boffa Surgical Group LLC

Practice address

5140 N California Ave Ste 780
Chicago, IL 60625-7066

Phone

(773) 235-8887

Fax

(773) 235-8882

NPI assigned

Jul 18, 2006

Last updated

May 5, 2011By the provider in NPPES

Organization subpart

Yes

Parent organization

BOFFA SURGICAL GROUP LLCAs reported in NPPES

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

Authorized official

Name

Dr. Carlos D Ortega, M.D.NPI 1972525269

Title

Employee

Phone

(773) 235-8887

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• Boffa Surgical Group LLC Doing business as

Part of

Boffa Medical Groupllc

Locations

Practitioners 2

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.

• Carlos David Ortega, M.D.

  • Surgery Physician
  • Chicago, IL
  • NPI 1972525269
  NPD (past) Authorized official
• Philip Theodoropoulos, M.D.

  • Surgery Physician
  • Skokie, IL
  • NPI 1588678692
  NPD (past)

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304553600000",
    "number": "1295753093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5140 N CALIFORNIA AVE STE 780",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606257066",
            "telephone_number": "773-235-8887",
            "fax_number": "773-235-8882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5140 N CALIFORNIA AVE STE 780",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606257066",
            "telephone_number": "773-235-8887",
            "fax_number": "773-235-8882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLOS ORTEGA MD SC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BOFFA SURGICAL GROUP LLC",
        "enumeration_date": "2006-07-18",
        "last_updated": "2011-05-05",
        "status": "A",
        "authorized_official_last_name": "ORTEGA",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "EMPLOYEE",
        "authorized_official_telephone_number": "773-235-8887",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036100042",
            "primary": true
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "IL",
            "license": "036100042",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "IL",
            "license": "036100042",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036100042",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSIL BSG",
            "identifier": "1630046",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS IL NIESS",
            "identifier": "1629966",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boffa Surgical Group LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amanda Carlo, NP
• Andrew David Carlo, MD, MPH
• Carlos F Pedrera MD SC
• Carlos F Smith DPM PC
• Carlos H Zambrano MD LLC
• Arlene Carlos, MS
• Christine Carlos
• Jessica Carlos, LCSW
• Jose Carlos
• Laura Leticia Carlos, OTR/L

• Surgery Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 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.