Individual provider Active NPI

Luis Maldonado Ortiz, D.C.

  • Chiropractor
  • Dallas, TX
National Provider Identifier
1619423654
Registry record updated May 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
13290 Issued in TX
Practice address
5100 Belt Line Rd
Suite 316
Dallas, TX 75254-7559
Phone
(972) 807-2749
Fax
(972) 807-2766
NPI assigned
Aug 30, 2016
Last updated
May 23, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 13290 TX Primary

Addresses

Primary practice location

5100 Belt Line Rd
Suite 316
Dallas, TX 75254-7559

Mailing address

3617 Shire Blvd Ste 200
Richardson, TX 75082-2301
Phone (469) 562-4347

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170110000712 TX Practitioner - Chiropractic 3678855343 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
100 Percent Chiropractic RCH, LLCGroup PAC ID 7113349952, 3 clinicians

Practice addresses (Care Compare)

3610 Shire Blvd
Suite 102
Richardson, TX 75082-2239
Phone (469) 562-4347

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13290TXMDGeneral Practice Dentistry

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1472515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558569600000",
    "number": "1619423654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3617 SHIRE BLVD STE 200",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750822301",
            "telephone_number": "469-562-4347",
            "fax_number": "972-807-2766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 BELT LINE RD",
            "address_2": "SUITE 316",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752547559",
            "telephone_number": "972-807-2749",
            "fax_number": "972-807-2766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO ORTIZ",
        "first_name": "LUIS",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-30",
        "last_updated": "2019-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "13290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.