Krysta Ortlieb

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

167 Polk St
Suite 300
Watertown, NY 13601-2770

Phone

(315) 782-7445

Fax

(315) 779-1184

NPI assigned

Apr 29, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Children'S Home of Jefferson County

  • Community/Behavioral Health Agency
  • Watertown, NY
  • NPI 1538455696
  NPD (past)
• Children'S Home of Jefferson County

  • Case Management Agency
  • Watertown, NY
  • NPI 1770625527
  NPD (past)

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

{
    "created_epoch": "1430265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430265600000",
    "number": "1740667724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6550",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136016550",
            "telephone_number": "315-782-7445",
            "fax_number": "315-779-1184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 POLK ST",
            "address_2": "SUITE 300",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012770",
            "telephone_number": "315-782-7445",
            "fax_number": "315-779-1184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTLIEB",
        "first_name": "KRYSTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-29",
        "last_updated": "2015-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fernando Ongkingco, MD
• Oral Surgery of Nny PLLC
• Manuel Orellana Flores, PT
• Jordon Mae Ormsby
• Douglas H. Ort II, LMHC
• Tiffany Graham Ostovar-Kermani, MD
• Sonya Otis
• Emma Elizabeth Ottinger, LMSW
• Sarah Eves Overton, PT, DPT
• Owen & Krawchenko MD PC

• Student in an Organized Health Care Education/Training Program in Watertown, NY
• Providers in Watertown, NY by specialty
• Student in an Organized Health Care Education/Training Program in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.