Active NPI
Juan A Ortiz, LADC-1 C.A.S.
- Addiction (Substance Use Disorder) Counselor
- Roxbury, MA
National Provider Identifier
1699852392
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 1593
- Practice address
- 45 Dimock St
Roxbury, MA 02119-1208 - Phone
- (617) 442-8800
- Fax
- (617) 442-6268
- NPI assigned
- Nov 1, 2006
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1593 | MA | Primary |
Addresses
Primary practice location
45 Dimock St
Roxbury, MA 02119-1208
Mailing address
55 Dimock St
Roxbury, MA 02119-1029
Phone (617) 442-8800
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1593 | MA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583884800000",
"number": "1699852392",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 DIMOCK ST",
"city": "ROXBURY",
"state": "MA",
"postal_code": "021191029",
"telephone_number": "617-442-8800",
"fax_number": "617-442-4088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45 DIMOCK ST",
"city": "ROXBURY",
"state": "MA",
"postal_code": "021191208",
"telephone_number": "617-442-8800",
"fax_number": "617-442-6268"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ORTIZ",
"first_name": "JUAN",
"middle_name": "A",
"credential": "LADC-1 C.A.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-01",
"last_updated": "2020-03-11",
"certification_date": "2020-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MA",
"license": "1593",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roxbury, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.