Individual provider Active NPI

Alfonso A Ortiz, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Las Vegas, NV
National Provider Identifier
1699915967
Registry record updated Jun 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
170235 Issued in NY
Practice address
540 N Nellis Blvd
Las Vegas, NV 89110
Phone
(702) 677-3609
Fax
(702) 431-0265
NPI assigned
Feb 26, 2009
Last updated
Jun 6, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 17966 NV
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 170235 NY Primary

Addresses

Primary practice location

540 N Nellis Blvd
Las Vegas, NV 89110

Mailing address

1181 Grand Concourse
Bronx, NY 10452-8503
Phone (718) 681-6565

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090319000516 NY Practitioner - EndocrinologyPractitioner - Internal Medicine 5193882066 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Shakespeare Operating LLCGroup PAC ID 0840604310, 144 clinicians
Essen Medical Associates, PCGroup PAC ID 1759353501, 264 clinicians

Practice addresses (Care Compare)

1250 Shakespeare Ave
Bronx, NY 10452-3012
Phone (646) 350-1633

2015 Grand Ave
FL 1
Bronx, NY 10453-4611
Phone (718) 583-7736

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
5733NVMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Essen Medical Associates, PC CurrentSince Mar 16, 2009 Accepting new patients
Medalliance Medical Health Services Inc CurrentSince Oct 1, 2020 Accepting new patients
Essen Medical Associates,PC CurrentSince Feb 2, 2022 Accepting new patients
Shakespeare Operating LLC CurrentSince May 27, 2023 Accepting new patients
Essen Medical Associates, PC CurrentSince Mar 16, 2009 Accepting new patients
House Call Medical Services of New York, PLLC Internal Medicine CurrentSince Feb 2, 2022 Accepting new patients

Locations

1181 Grand Concourse
Bronx, NY 10452
Phone (718) 457-7443

1250 Shakespeare Ave
Bronx, NY 10452
Phone (646) 350-1633

1371 Seabury Ave
Bronx, NY 10461
Phone (718) 294-6200

1434 Williamsbridge Rd
Ste A
Bronx, NY 10461

2015 Grand Concourse
Bronx, NY 10453
Phone (718) 294-6200

2505 Grand Ave
Bronx, NY 10468
Phone (718) 295-1400

625 E Fordham Rd
Bronx, NY 10458
Phone (718) 409-3433

8989 Union Tpke
Ste A
Glendale, NY 11385
Phone (718) 746-0400

19544 Woodhull Ave
Jamaica, NY 11423
Phone (718) 336-2345

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1235606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528243200000",
    "number": "1699915967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1181 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104528503",
            "telephone_number": "718-681-6565",
            "fax_number": "718-681-1201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 N NELLIS BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89110",
            "telephone_number": "702-677-3609",
            "fax_number": "702-431-0265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ",
        "first_name": "ALFONSO",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-26",
        "last_updated": "2018-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "17966",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "170235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.