Individual provider Active NPI

Lisa Maria Ortiz, NP

  • Pediatric Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1629940960
Registry record updated Sep 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
383882 Issued in NY
Practice address
374 Stockholm St
Brooklyn, NY 11237-4006
Phone
(718) 963-7272
NPI assigned
Sep 17, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 383882 NY Primary

Addresses

Primary practice location

374 Stockholm St
Brooklyn, NY 11237-4006

Mailing address

371 Stockholm St
Brooklyn, NY 11237-4194
Phone (718) 963-7272

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20251120003064 NY Practitioner - Nurse Practitioner 6406348135 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

179 Ave at the CMN
Suite 214
Shrewsbury, NJ 07702

PO
Suite 7928
Philadelphia, PA 19170-0001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
383882NYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wyckoff Professional Medical Services, PC CurrentSince Oct 1, 2025 Accepting new patients
Wyckoff Emergency Medicine Services, P.C. PastSince Sep 21, 2025 Accepting new patients

Locations

1411 Myrtle Ave
Brooklyn, NY 11237
Phone (718) 907-4301

374 Stockholm St
Brooklyn, NY 11237
Phone (718) 963-6485

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1758067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758067200000",
    "number": "1629940960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "371 STOCKHOLM ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112374194",
            "telephone_number": "718-963-7272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 STOCKHOLM ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112374006",
            "telephone_number": "718-963-7272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ",
        "first_name": "LISA",
        "middle_name": "MARIA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-17",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "383882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.