Individual provider Active NPI

Ginna Mariel Lora Ortega, PA

  • Physician Assistant
  • Bronx, NY
National Provider Identifier
1659043925
Registry record updated Jan 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
029359 Issued in NY
Practice address
2626 Halperin Ave
Bronx, NY 10461-2631
Phone
(718) 583-7736
Fax
(718) 537-6180
NPI assigned
Oct 4, 2021
Last updated
Jan 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X PA9115070 FL
Physician Assistant 363A00000X 029359 NY Primary

Addresses

Primary practice location

2626 Halperin Ave
Bronx, NY 10461-2631

Mailing address

2626 Halperin Ave
Bronx, NY 10461-2631
Phone (718) 618-0461

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
I20230103001974 NY Practitioner - Physician Assistant 8022409663 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Shakespeare Operating LLCGroup PAC ID 0840604310, 144 clinicians

Practice addresses (Care Compare)

1250 Shakespeare Ave
Bronx, NY 10452-3012
Phone (646) 350-1633

3991 White Plains Rd
Suite C
Bronx, NY 10466-3001
Phone (646) 350-1633

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9115070FLMDPrimary Care Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
Essen Medical Associates, PC CurrentSince Oct 1, 2024 Accepting new patients
Essen Medical Associates, PC CurrentSince Oct 1, 2024 Accepting new patients

Locations

1250 Shakespeare Ave
Bronx, NY 10452
Phone (646) 350-1633

2015 Grand Concourse
Bronx, NY 10453
Phone (718) 294-6200

2505 Grand Ave
Bronx, NY 10468
Phone (718) 295-1400

3991 White Plains Rd
Ste C
Bronx, NY 10466
Phone (718) 925-3454

8989 Union Tpke
Glendale, NY 11385
Phone (718) 480-6207

8989 Union Tpke
Ste A
Glendale, NY 11385
Phone (718) 746-0400

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 4

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": "1633305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1659043925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2626 HALPERIN AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612631",
            "telephone_number": "718-618-0461",
            "fax_number": "718-537-6180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2626 HALPERIN AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612631",
            "telephone_number": "718-583-7736",
            "fax_number": "718-537-6180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LORA ORTEGA",
        "first_name": "GINNA",
        "middle_name": "MARIEL",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-04",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "PA9115070",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "029359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.