Individual provider Active NPI

Justin Ryan Ortal, PA

  • Physician Assistant
  • Riverside, CA
National Provider Identifier
1366387698
Registry record updated Apr 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
5588 Osburn PL
Riverside, CA 92506-2170
Phone
(808) 291-1134
NPI assigned
Apr 22, 2026
Last updated
Apr 22, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

5588 Osburn PL
Riverside, CA 92506-2170

Mailing address

5588 Osburn PL
Riverside, CA 92506-2170

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4646 Brockton Ave
Suite 203
Riverside, CA 92506-0102

6529 Riverside Ave
Suite 132
Riverside, CA 92506-3100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1776816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776816000000",
    "number": "1366387698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5588 OSBURN PL",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5588 OSBURN PL",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062170",
            "telephone_number": "808-291-1134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTAL",
        "first_name": "JUSTIN RYAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-04-22",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.