Individual provider Active NPI

Julio Enrique Ortiz, MD

  • Plastic and Reconstructive Surgery Physician
  • San Antonio, TX
National Provider Identifier
1679647853
Registry record updated Aug 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
E5197 Issued in TX
Practice address
13109 Hunters Ledge
San Antonio, TX 78230-2047
Phone
(210) 492-7766
Fax
(210) 492-9325
NPI assigned
Nov 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X E5197 TX Primary

Addresses

Primary practice location

13109 Hunters Ledge
San Antonio, TX 78230-2047

Mailing address

13109 Hunters Ledge
San Antonio, TX 78230-2047
Phone (210) 957-9100

Other identifiers 2

IdentifierTypeStateIssuer
00H13FOtherTXBCBSTX
089690402MedicaidTX

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E5197TXMDPlastic and Reconstructive Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502841600000",
    "number": "1679647853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13109 HUNTERS LEDGE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782302047",
            "telephone_number": "210-957-9100",
            "fax_number": "210-492-9325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13109 HUNTERS LEDGE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782302047",
            "telephone_number": "210-492-7766",
            "fax_number": "210-492-9325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ",
        "first_name": "JULIO",
        "middle_name": "ENRIQUE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2017-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "TX",
            "license": "E5197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "00H13F",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "089690402",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.