Individual provider Active NPI

Noel Ortega, PT

  • Physical Therapist
  • Chantilly, VA
National Provider Identifier
1306512595
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305216028 Issued in VA
Practice address
25370 Eastern Marketplace PLZ Ste 120
Chantilly, VA 20152-1428
Phone
(571) 339-3150
NPI assigned
Aug 18, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305216028 VA Primary

Addresses

Primary practice location

25370 Eastern Marketplace PLZ Ste 120
Chantilly, VA 20152-1428

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, VA, DC3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20211223000803 NY Practitioner - Physical Therapist in Private Practice 6305237512
I20250912002929 VA Practitioner - Physical Therapist in Private Practice 6305237512 Reassigns benefits to 2 organizations
I20251104001020 DC Practitioner - Physical Therapist in Private Practice 6305237512 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tidewater Physical Therapy LLCGroup PAC ID 6406759281, 225 clinicians
Professional Sportscare and Rehab LLCGroup PAC ID 9335137363, 103 clinicians

Practice addresses (Care Compare)

25370 Eastern Marketplace PLZ
Suite 120
Chantilly, VA 20152-1428
Phone (571) 339-3150

43330 Junction PLZ
Suite 122
Ashburn, VA 20147-3407
Phone (703) 972-1040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
047271NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Apr 1, 2026 Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Apr 1, 2026 Accepting new patients
Professional Sportscare & Rehab, LLC Physical Therapist CurrentSince Jul 24, 2025 Accepting new patients
Professional Sportscare & Rehab, LLC Physical Therapist PastSince Jul 24, 2025 Accepting new patients

Locations

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

1600 Wilson Blvd
Ste 102
Arlington, VA 22209
Phone (301) 464-4500

11662 Sudley Manor Dr
#50B
Manassas, VA 20109
Phone (571) 321-5720

25370 Eastern Marketplace Plz
Ste 120
South Riding, VA 20152
Phone (571) 339-3150

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1629244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1306512595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25370 EASTERN MARKETPLACE PLZ STE 120",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201521428",
            "telephone_number": "571-339-3150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTEGA",
        "first_name": "NOEL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-18",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305216028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chantilly, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.