Timothy Eun Ortlip, M.D.

Primary specialty

Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X

License

A155301 Issued in CA

Practice address

2557 Mowry Ave Ste 30
Fremont, CA 94538

Phone

(510) 248-1590

Fax

(510) 795-1459

NPI assigned

Apr 10, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

OtolaryngologyAlso: Plastic and Reconstructive Surgery

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Og Medical IncGroup PAC ID 4587029681, 2 clinicians

County of Santa ClaraGroup PAC ID 1254244973, 1,000 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tortlip231171@santaclaravalley.direct-ci.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• County of Santa Clara

  dba Josefina Narvaez Mental Health Center MH Aoa

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Jose, CA
  • NPI 1699885079
  Medicare reassignment Care Compare group NPD
• Og Medical Inc

  • Facial Plastic Surgery Physician
  • San Francisco, CA
  • NPI 1386392264

  Otolaryngology

  Medicare reassignment Care Compare group NPD
• County of Santa Clara

  dba Valley Health Center at Moorpark-Puentes

  • Federally Qualified Health Center (FQHC)
  • San Jose, CA
  • NPI 1336135912

  Otolaryngology

  NPD
• County of Santa Clara

  dba SCVMC Outpatient Pharmacy

  • Pharmacy
  • San Jose, CA
  • NPI 1891871919
  NPD
• County of Santa Clara

  dba Inpatient Acute/Outpatient Facility Services

  • General Acute Care Hospital
  • San Jose, CA
  • NPI 1063406551
  NPD (past)

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

{
    "created_epoch": "1334016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548720000000",
    "number": "1518223981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2557 MOWRY AVE STE 30",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381614",
            "telephone_number": "510-248-1590",
            "fax_number": "510-795-1459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2557 MOWRY AVE STE 30",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "94538",
            "telephone_number": "510-248-1590",
            "fax_number": "510-795-1459"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "925 Chestnut St Fl 6",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191074204",
            "country_code": "US",
            "telephone_number": "215-955-6760",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2557 Mowry Ave Ste 30",
            "address_purpose": "LOCATION",
            "city": "Fremont",
            "state": "CA",
            "postal_code": "94538",
            "country_code": "US",
            "telephone_number": "510-248-1590",
            "fax_number": "510-795-1459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ORTLIP",
        "first_name": "TIMOTHY",
        "middle_name": "EUN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-10",
        "last_updated": "2019-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "PA",
            "license": "MD460908",
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "PA",
            "license": "MD460908",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "CA",
            "license": "A155301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Orthopaedic Sports Specialists a Medical Corp
• Dalaila Ortiz Rodriguez
• Bianca Ortiz
• Brenda Ortiz
• Natalie Merced Ortiz
• Cody Lee Ortmann
• Patricia Osage
• Paul Ignacio Oseguera
• Farah Osmani, NP
• Monica Osorio

• Facial Plastic Surgery Physician in Fremont, CA
• Providers in Fremont, CA by specialty
• Facial Plastic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2019; 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.
• 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.