NPIMap

Individual provider Active NPI

Jeremy Michael Ortiz, PA

  • Medical Physician Assistant
  • Lewisberry, PA
National Provider Identifier
1538548334
Registry record updated May 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
629D Lowther Rd
Lewisberry, PA 17339-9527
Phone
(717) 932-5200
Fax
(717) 932-3095
NPI assigned
May 26, 2015
Last updated
May 26, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X NU Primary

Addresses

Primary practice location

629D Lowther Rd
Lewisberry, PA 17339-9527

Mailing address

629D Lowther Rd
Lewisberry, PA 17339-9527
Phone (717) 932-5200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150812008512 PA Practitioner - Physician Assistant 7810202314 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

51 Business Campus Way
Suite 100
Duncannon, PA 17020-9596
Phone (717) 932-5200

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Jul 1, 2017 Accepting new patients
Penn State Health Medical Group, LLC CurrentSince Oct 1, 2022 Accepting new patients
Penn State Health Medical Group, LLC CurrentSince Oct 1, 2022 Accepting new patients
Geisinger Clinic CurrentSince Jul 1, 2017 Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

1120 Cocoa Ave
Hershey, PA 17033
Phone (717) 533-4141

500 University Dr
#410
Hershey, PA 17033
Phone (717) 531-1159

629D Lowther Rd
Lewisberry, PA 17339
Phone (717) 938-2765

Organizations & group practices 7

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 7

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": "1432598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432598400000",
    "number": "1538548334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629D LOWTHER RD",
            "city": "LEWISBERRY",
            "state": "PA",
            "postal_code": "173399527",
            "telephone_number": "717-932-5200",
            "fax_number": "717-932-3095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629D LOWTHER RD",
            "city": "LEWISBERRY",
            "state": "PA",
            "postal_code": "173399527",
            "telephone_number": "717-932-5200",
            "fax_number": "717-932-3095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ",
        "first_name": "JEREMY",
        "middle_name": "MICHAEL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-26",
        "last_updated": "2015-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisberry, PA

Sources for this page

Verify at the official NPI Registry.