Deofil Luzod Orteza, M.D.

Key facts

NPI

1699790287

Entity type

Individual (NPI type 1)

Primary specialty

Anesthesiology Physician 207L00000X

License

036054242 (IL)

Practice address

530 Park Ave E
Princeton, IL 61356

Phone

(815) 875-2811

NPI assigned

Jul 13, 2006

Sex

Male

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

HHS exclusion list flag

The National Provider Directory flags this NPI as appearing on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Specialties & licenses

Addresses

Other identifiers

Electronic endpoints

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 15, 2020.

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602720000000",
    "number": "1699790287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 PARK AVE E",
            "city": "PRINCETON",
            "state": "IL",
            "postal_code": "61356",
            "telephone_number": "815-875-2811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 PARK AVE E",
            "city": "PRINCETON",
            "state": "IL",
            "postal_code": "61356",
            "telephone_number": "815-875-2811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTEZA",
        "first_name": "DEOFIL",
        "middle_name": "LUZOD",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036054242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "00600116",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORGANIZATION IDENTIFIER",
            "identifier": "1023186517",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036054242",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCARE LEGACY #",
            "identifier": "L06500",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "deofil.orteza@perry.cernerdirect.com",
            "affiliation": "N",
            "address_1": "530 Park Ave E",
            "city": "Princeton",
            "state": "IL",
            "country_code": "US",
            "postal_code": "61356",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Princeton, IL

• North Central Behavioral Health Systems, Inc.
• Northland Hearing Centers, Inc.
• Heidi Amanda Olsen
• One Ten Counseling Services, LLC
• Options Eap
• Osf Healthcare System
• Osf Healthcare System
• Osf Healthcare System
• Osf Healthcare System
• Osf Healthcare System

All providers in Princeton, IL · Anesthesiology Physician in Illinois