Active NPI
Alberto Ortiz, P.A.-C
- Physician Assistant
- Wharton, TX
National Provider Identifier
1720043060
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA01220
- Practice address
- 2100 Regional Medical Dr
Wharton, TX 77488-9719 - Phone
- (979) 532-1700
- Fax
- (979) 532-6792
- NPI assigned
- Apr 19, 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA01220 | TX | Primary |
Addresses
Primary practice location
2100 Regional Medical Dr
Wharton, TX 77488-9719
Mailing address
2100 Regional Medical Dr
Wharton, TX 77488-9719
Phone (979) 532-1700
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P01090522 | Other | TX | RAILROAD MEDICARE PTAN |
| 875N32 | Other | TX | BC/BS # |
| 990005691 | Other | TX | RAILROAD GBA - RAILROAD MEDICARE |
| 306211902 | Medicaid | TX |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA01220 | TX | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Texas Medical Clinics, P.a. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Physician
- East Bernard, TX
- NPI 1114077427
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1355097600000",
"number": "1720043060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2100 REGIONAL MEDICAL DR",
"city": "WHARTON",
"state": "TX",
"postal_code": "774889719",
"telephone_number": "979-532-1700",
"fax_number": "979-532-6792"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 REGIONAL MEDICAL DR",
"city": "WHARTON",
"state": "TX",
"postal_code": "774889719",
"telephone_number": "979-532-1700",
"fax_number": "979-532-6792"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ORTIZ",
"first_name": "ALBERTO",
"name_prefix": "Mr.",
"credential": "P.A.-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-19",
"last_updated": "2012-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA01220",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE PTAN",
"identifier": "P01090522",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS #",
"identifier": "875N32",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD GBA - RAILROAD MEDICARE",
"identifier": "990005691",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "306211902",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wharton, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.