Pedro Ortiz

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9119021 Issued in FL

Practice address

1200 Deltona Blvd Apt 40a
Deltona, FL 32725-6386

Phone

(386) 202-6025

NPI assigned

Apr 19, 2017

Last updated

Jul 24, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pedro.ortiz@nefhs.eclinicaldirectplus.com

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.

• Northeast Florida Health Services, Inc.

  dba Family Health Source

  • Federally Qualified Health Center (FQHC)
  • Pierson, FL
  • NPI 1992792311
  Medicare reassignment
• Northeast Florida Health Services Inc

  dba Family Health Source

  • Federally Qualified Health Center (FQHC)
  • Deltona, FL
  • NPI 1427605534
  NPD
• Northeast Florida Health Services, Inc.

  dba Family Health Source

  • Dental Clinic/Center
  • Deltona, FL
  • NPI 1164196861
  NPD
• Northeast Florida Health Services, Inc.

  dba Family Health Source

  • Federally Qualified Health Center (FQHC)
  • South Daytona, FL
  • NPI 1396282208
  NPD

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

{
    "created_epoch": "1492560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1629502463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 S WOODLAND BLVD STE 3",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327207464",
            "telephone_number": "386-202-6025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 DELTONA BLVD APT 40A",
            "city": "DELTONA",
            "state": "FL",
            "postal_code": "327256386",
            "telephone_number": "386-202-6025"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "99 Calle Guillermo Riefkohl",
            "address_purpose": "LOCATION",
            "city": "Patillas",
            "state": "PR",
            "postal_code": "00723",
            "country_code": "US",
            "telephone_number": "787-839-4320 x1255",
            "fax_number": "787-271-0004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ORTIZ",
        "first_name": "PEDRO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-19",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": "PR",
            "license": "008557",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9119021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "PA9119021",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTRY NUMBER",
            "identifier": "205411",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Orlando Vamc
• Kristeen R Ortega, MD
• Alondra Ortiz de Jesus, PA-C
• Frank Ortiz
• Megan Luz Ortiz
• Paayjan Medical Center
• Paayjan, PA
• Alenette Theresa Pabon
• Tereasa Padilla, RBT
• Kevin Matthew Palmer, MD

• Medical Physician Assistant in Deltona, FL
• Providers in Deltona, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.