Active NPI
Kyle Joshua Fortinsky, MD
- Gastroenterology Physician
- Orange, CA
National Provider Identifier
1710403498
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 150474
- Practice address
- 333 City Blvd W Ste 400
Orange, CA 92868-2994 - Phone
- (714) 456-6745
- NPI assigned
- Aug 15, 2017
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 150474 | CA | Primary |
Addresses
Primary practice location
333 City Blvd W Ste 400
Orange, CA 92868-2994
Mailing address
12216 Pintado
Irvine, CA 92618-0275
Phone (949) 241-1239
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 150474 | CA | MD | Gastroenterology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1502755200000",
"number": "1710403498",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12216 PINTADO",
"city": "IRVINE",
"state": "CA",
"postal_code": "926180275",
"telephone_number": "949-241-1239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 CITY BLVD W STE 400",
"city": "ORANGE",
"state": "CA",
"postal_code": "928682994",
"telephone_number": "714-456-6745"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORTINSKY",
"first_name": "KYLE",
"middle_name": "JOSHUA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-08-15",
"last_updated": "2017-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Gastroenterology",
"state": "CA",
"license": "150474",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.