Active NPI
Miguel Angel Ortiz Rivera, MD
- Surgery Physician
- Springfield, IL
National Provider Identifier
1386276392
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 125080748
- Practice address
- 701 N 1St
Suite D308
Springfield, IL 62702 - Phone
- (217) 545-4401
- Fax
- (217) 545-1793
- NPI assigned
- Feb 7, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Surgery Physician | 208600000X | 125080748 | IL | Primary |
Addresses
Primary practice location
701 N 1St
Suite D308
Springfield, IL 62702
Mailing address
P. O. Box 19638
Springfield, IL 62794-9638
Phone (217) 545-4401
Other practice location 1
Paseo Dr. Jose Celso Barbosa
San Juan, PR 00921
Phone (787) 758-2525
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220728000477 | IL | Order and Referring Only - General Surgery | 5496137143 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1581033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656201600000",
"number": "1386276392",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P. O. BOX 19638",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627949638",
"telephone_number": "217-545-4401",
"fax_number": "217-545-1793"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 N 1ST",
"address_2": "SUITE D308",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "62702",
"telephone_number": "217-545-4401",
"fax_number": "217-545-1793"
}
],
"practiceLocations": [
{
"address_1": "Paseo Dr. Jose Celso Barbosa",
"address_purpose": "LOCATION",
"city": "San Juan",
"state": "PR",
"postal_code": "00921",
"country_code": "US",
"telephone_number": "787-758-2525",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ORTIZ RIVERA",
"first_name": "MIGUEL",
"middle_name": "ANGEL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-02-07",
"last_updated": "2022-06-26",
"certification_date": "2022-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IL",
"license": "125080748",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.