Organization Active NPI

Andrew Kortz MD PA

  • Ophthalmology Physician
  • Pensacola, FL
National Provider Identifier
1730164096
Registry record updated Feb 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
ANDREW KORTZ MD PA
Practice address
4570 Isabella Ingram Dr
Pensacola, FL 32504-5026
Phone
(850) 438-6555
Fax
(850) 438-6559
NPI assigned
Dec 9, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2016

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

Authorized official

Name
Andrew E Kortz, MDNPI 1295710556
Title
Owner
Phone
(850) 932-2000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

4570 Isabella Ingram Dr
Pensacola, FL 32504-5026

Mailing address

4570 Isabella Ingram Dr
Pensacola, FL 32504-5026
Phone (850) 438-6555

Other identifiers 3

IdentifierTypeStateIssuer
265779100MedicaidFL
529918320MedicaidAL
DB5369OtherFLMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040528000875 FL Part B Supplier - Clinic/Group Practice 9335120856 Receives reassigned benefits from 1 practitioner
Practice locations: Marianna, FL; Pensacola, FL; Panama City, FL; Niceville, FL; Fort Walton Beach, FL; Defuniak Springs, FL; Creastview, FL; Chipley, FL

National Provider Directory

National Provider Directory

Locations

355 Beal Pkwy N
Ft Walton Bch, FL 32548
Phone (850) 744-0118

115 Bailey Dr
Niceville, FL 32578
Phone (850) 678-5338

4570 Isabella Ingram Dr
Pensacola, FL 32504
Phone (850) 438-6555

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455753600000",
    "number": "1730164096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4570 ISABELLA INGRAM DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325045026",
            "telephone_number": "850-438-6555",
            "fax_number": "850-438-6559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4570 ISABELLA INGRAM DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325045026",
            "telephone_number": "850-438-6555",
            "fax_number": "850-438-6559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDREW KORTZ MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-09",
        "last_updated": "2016-02-18",
        "status": "A",
        "authorized_official_last_name": "KORTZ",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-932-2000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "265779100",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529918320",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DB5369",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.