NPIMap

Individual provider Active NPI

Juan Pablo Moreno-Ortiz, MD

  • Nephrology Physician
  • Mesa, AZ
National Provider Identifier
1528521515
Registry record updated May 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
71795 Issued in AZ
Practice address
6553 E Baywood Ave Ste 205
Mesa, AZ 85206-1754
Phone
(480) 626-2020
NPI assigned
Apr 8, 2019
Last updated
May 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X R77241 AZ
Nephrology Physician 207RN0300X A179000 CA
Nephrology Physician 207RN0300X 71795 AZ Primary

Addresses

Primary practice location

6553 E Baywood Ave Ste 205
Mesa, AZ 85206-1754

Mailing address

3333 E Camelback Rd Ste 180
Phoenix, AZ 85018-2396
Phone (602) 759-6883

Other practice location 1

4150 V St Ste 3500
Sacramento, CA 95817-1460
Phone (916) 734-3682

Other names 1

  • Juan Pablo Moreno Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240625003910 AZ Practitioner - Nephrology 1759616196 Reassigns benefits to 1 organization
I20241121000757 TX Practitioner - Internal MedicinePractitioner - Nephrology 1759616196 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Texas a & M University System, HSC, College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Akdhc LLCGroup PAC ID 8123912136, 125 clinicians

Practice addresses (Care Compare)

103 Medicine Way Rd
Peridot, AZ 85542-0787
Phone (928) 475-1400

6553 E Baywood Ave
Suite 205
Mesa, AZ 85206-1754
Phone (480) 626-2020

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.2 of 100Reported as group
Quality
67.68
Promoting interoperability
100
Improvement activities
40
Cost
76.33

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R77241AZMDInternal Medicine Physician
A179000CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Carlos Apache Healthcare Corporation Current Accepting new patients
Akdhc, LLC Nephrology CurrentSince Jul 15, 2024 Accepting new patients
Akdhc Surgery Center, LLC Nephrology Current Accepting new patients
San Carlos Apache Healthcare Corporation CurrentSince Sep 1, 2024 Accepting new patients
Akdhc, LLC Nephrology CurrentSince Jul 15, 2024 Accepting new patients
Regents of the Univ of Ca Past Accepting new patients

Locations

6553 E Baywood Ave
Ste 205
Mesa, AZ 85206
Phone (480) 396-9922

103 Medicine Way Rd
Peridot, AZ 85542
Phone (928) 475-1200

3320 N 2nd St
Phoenix, AZ 85012
Phone (602) 200-8288

3333 E Camelback Rd
Ste 180
Phoenix, AZ 85018
Phone (602) 997-0484

1501 N Campbell Ave
Rm 6336
Tucson, AZ 85724
Phone (520) 626-2761

Interoperability endpoints

  • Direct secure messaging: juan.moreno-ortiz.1@11625.direct.athenahealth.com

Organizations & group practices 6

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1554681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715990400000",
    "number": "1528521515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 E CAMELBACK RD STE 180",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182396",
            "telephone_number": "602-759-6883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6553 E BAYWOOD AVE STE 205",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061754",
            "telephone_number": "480-626-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4150 V St Ste 3500",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958171460",
            "country_code": "US",
            "telephone_number": "916-734-3682",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORENO-ORTIZ",
        "first_name": "JUAN",
        "middle_name": "PABLO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-08",
        "last_updated": "2024-05-18",
        "certification_date": "2024-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "R77241",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A179000",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "AZ",
            "license": "71795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUAN",
            "last_name": "MORENO",
            "middle_name": "PABLO",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.