Individual provider Active NPI

Felicia Nicolemarie Ortiz

  • Medical Physician Assistant
  • Pomona, CA
National Provider Identifier
1699516088
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA65128 Issued in CA
Practice address
309 E 2ND St
Pomona, CA 91766-1854
Phone
(909) 623-6116
NPI assigned
Jun 1, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Medical Physician Assistant 363AM0700X PA65128 CA Primary

Addresses

Primary practice location

309 E 2ND St
Pomona, CA 91766-1854

Mailing address

309 E 2ND St
Pomona, CA 91766-1854

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20250109000453 CA Practitioner - Physician Assistant 7416485149 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1151 E Walnut St
Ontario, CA 91761-6155
Phone (909) 467-1425

184 E Highland Ave
San Bernardino, CA 92404-3658
Phone (909) 882-4788

190 E Highland Ave
San Bernardino, CA 92404-3658
Phone (909) 882-4788

308 N la Cadena Dr
Colton, CA 92324-2946
Phone (909) 321-0700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
65128CAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
PA65128CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Unicare Community Health Center, Inc. CurrentSince Jan 6, 2025 Accepting new patients
Unicare Community Health Center, Inc. CurrentSince Jan 6, 2025 Accepting new patients

Locations

107 N McKinley St
Corona, CA 92879
Phone (951) 358-0141

1151 E Walnut St
Ontario, CA 91761
Phone (909) 467-0797

437 N Euclid Ave
Ontario, CA 91762
Phone (909) 749-1835

1501 E Holt Ave
Ste A
Pomona, CA 91767
Phone (909) 623-3600

Organizations & group practices 3

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": "1717200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1699516088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 E 2ND ST",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917661854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 E 2ND ST",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917661854",
            "telephone_number": "909-623-6116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ",
        "first_name": "FELICIA",
        "middle_name": "NICOLEMARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-01",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA65128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.