Active NPI
Shaun Michael Ortega, P.A.
- Physician Assistant
- Independence, OH
National Provider Identifier
1710988100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 50001422
- Practice address
- 6701 Rockside Rd
Suite 103
Independence, OH 44131-2358 - Phone
- (216) 369-2800
- Fax
- (216) 369-0456
- NPI assigned
- Aug 9, 2005
- Last updated
- Oct 12, 2012
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 50001422 | OH | Primary |
Addresses
Primary practice location
6701 Rockside Rd
Suite 103
Independence, OH 44131-2358
Mailing address
7580 Northcliff Ave
Suite 500
Brooklyn, OH 44144-3270
Phone (216) 472-2741
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0069895 | Medicaid | OH |
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
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Collis, Kim & Associates, Inc. | Past | Accepting new patients | |
| Ben D. Ortega , M.D. Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Specialist
- Parma, OH
- NPI 1700044732
-
- Rheumatology Physician
- Broadview HTS, OH
- NPI 1336140987
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350000000000",
"number": "1710988100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7580 NORTHCLIFF AVE",
"address_2": "SUITE 500",
"city": "BROOKLYN",
"state": "OH",
"postal_code": "441443270",
"telephone_number": "216-472-2741",
"fax_number": "216-472-2739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6701 ROCKSIDE RD",
"address_2": "SUITE 103",
"city": "INDEPENDENCE",
"state": "OH",
"postal_code": "441312358",
"telephone_number": "216-369-2800",
"fax_number": "216-369-0456"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ORTEGA",
"first_name": "SHAUN",
"middle_name": "MICHAEL",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-09",
"last_updated": "2012-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OH",
"license": "50001422",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0069895",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Independence, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.