Active NPI
Leonel Ortiz, PTA
- Physical Therapy Assistant
- Goodyear, AZ
National Provider Identifier
1669022778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 013973
- Practice address
- 304 N Los Robles Dr
Goodyear, AZ 85338-1425 - Phone
- (602) 573-6943
- NPI assigned
- Sep 19, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 013973 | AZ | Primary |
Addresses
Primary practice location
304 N Los Robles Dr
Goodyear, AZ 85338-1425
Mailing address
304 N Los Robles Dr
Goodyear, AZ 85338-1425
Phone (602) 573-6943
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 013973 | AZ | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568851200000",
"number": "1669022778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "304 N LOS ROBLES DR",
"city": "GOODYEAR",
"state": "AZ",
"postal_code": "853381425",
"telephone_number": "602-573-6943"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "304 N LOS ROBLES DR",
"city": "GOODYEAR",
"state": "AZ",
"postal_code": "853381425",
"telephone_number": "602-573-6943"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ORTIZ",
"first_name": "LEONEL",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-09-19",
"last_updated": "2019-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "AZ",
"license": "013973",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Goodyear, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.