Individual provider Active NPI

Abram Ortega, DMD

  • General Practice Dentistry
  • Austin, TX
National Provider Identifier
1508411372
Registry record updated Sep 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN26433 Issued in FL
Practice address
3909 N Ih 35 Ste A1
Austin, TX 78722-1529
Phone
(512) 458-5600
NPI assigned
Aug 7, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 35368 TX
General Practice Dentistry 1223G0001X DN26433 FL Primary

Addresses

Primary practice location

3909 N Ih 35 Ste A1
Austin, TX 78722-1529

Mailing address

512 Paul Jones Pass
Austin, TX 78748-2924
Phone (210) 421-6180

Other practice location 1

23036 Sr-54 E
Suite 403
Lutz, FL 33549
Phone (813) 909-1317

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211008000033 FL Order and Referring Only - DentistPractitioner - Dentist 0840698619

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN26433FLMDGeneral Practice Dentistry
35368TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Coast Florida P.a. Past Accepting new patients
Coast Florida P.a. PastSince Jun 22, 2021 Accepting new patients

Networks

  • Freedom Health HMO Network

Organizations & group practices 2

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": "1565136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631491200000",
    "number": "1508411372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 PAUL JONES PASS",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787482924",
            "telephone_number": "210-421-6180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3909 N IH 35 STE A1",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787221529",
            "telephone_number": "512-458-5600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23036 SR-54 E",
            "address_2": "Suite 403",
            "address_purpose": "LOCATION",
            "city": "Lutz",
            "state": "FL",
            "postal_code": "33549",
            "country_code": "US",
            "telephone_number": "813-909-1317",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ORTEGA",
        "first_name": "ABRAM",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-07",
        "last_updated": "2021-09-13",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "35368",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN26433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.