Omar Antonio Andino-Ortega, MD
Individual provider Active NPI Obstetrics & Gynecology Physician · Mesa, AZ
NPI 1366028748 · NPPES record last updated Sep 16, 2025
Key facts
- NPI
- 1366028748
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- 75506 (AZ)
- Practice address
- 1142 E Southern Ave Ste C101
Mesa, AZ 85204-5055 - Phone
- (480) 821-3600
- NPI assigned
- Mar 24, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Obstetrics/Gynecology
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Momdoc LLC
Practice addresses (Care Compare)
1142 E Southern Ave
Suite 101
Mesa, AZ 85204-5056
Phone (480) 821-3600
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250818003435 | AZ | Practitioner - Obstetrics/Gynecology | 8224537147 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Momdoc, LLC | Obstetrics & Gynecology | Current |
Accepting new patients |
| Healthy Pregnancy Perinatology, LLC | Past | Accepting new patients | |
| Mi Doctora | Obstetrics & Gynecology | Past |
Accepting new patients |
| Banner Gateway Medical Center | Past | Accepting new patients |
Locations
2545 W Frye Rd
Ste 9
Chandler, AZ 85224
Phone (480) 505-4258
2055 W Frye Rd
Chandler, AZ 85224
2545 W Frye Rd
Ste 5
Chandler, AZ 85224
Phone (480) 821-3610
1760 E Pecos Rd
Ste 516
Gilbert, AZ 85295
Phone (480) 619-4486
1760 E Pecos Rd
Gilbert, AZ 85295
Phone (480) 821-2883
21300 N John Wayne Pkwy
Ste 121
Maricopa, AZ 85139
Phone (520) 494-7045
1142 E Southern Ave
Ste 101
Mesa, AZ 85204
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 75506 | AZ | Yes |
Addresses
Primary practice location
1142 E Southern Ave Ste C101
Mesa, AZ 85204-5055
Mailing address
3150 E Ray Rd Apt 553
Gilbert, AZ 85296-1691
Phone (787) 466-1320
Other providers in Mesa, AZ
- Sadie Anderson
- Sandra Sue Anderson
- Weston Taylor Anderson
- Andersons Nutrition
- Robert Anderton
- Josseline Andrade Carrillo
- Andre C Matthews
- Christian Andreen
- Andrew T Weir, DDS, PC
- Amber Marie Andrews
All providers in Mesa, AZ · Obstetrics & Gynecology Physician in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 16, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.