Individual provider Active NPI

Alfonso Antonio Hernandez - Ortiz, M.D.

  • Psychiatry Physician
  • Ponce, PR
National Provider Identifier
1750431953
Registry record updated Apr 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
8745 Issued in PR
Practice address
2225 Ponce Byp Ste 709
Ponce, PR 00717-1379
Phone
(787) 259-1265
Fax
(787) 259-1266
NPI assigned
Jan 11, 2007
Last updated
Apr 22, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 8745 PR
Psychiatry Physician 2084P0800X 8745 PR Primary

Addresses

Primary practice location

2225 Ponce Byp Ste 709
Ponce, PR 00717-1379

Mailing address

2225 Ponce Byp Ste 709
Ponce, PR 00717-1379
Phone (787) 259-1265

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070302000291 PR Practitioner - Psychiatry 9335241751 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Ponce School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1805 Paseo Las Colinas
Suite 4
Ponce, PR 00717-1805
Phone (787) 259-1265

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
8745PRMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emotional & Mental Consulting Services CSP CurrentSince Feb 23, 2007 Accepting new patients

Locations

1805 Paseo La Colonia
Ste 4
Ponce, PR 00717
Phone (787) 259-1265

2225 Ponce Byp
Ste 709
Ponce, PR 00717
Phone (787) 259-1265

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366588800000",
    "number": "1750431953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2225 PONCE BYP STE 709",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007171379",
            "telephone_number": "787-259-1265",
            "fax_number": "787-259-1266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 PONCE BYP STE 709",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007171379",
            "telephone_number": "787-259-1265",
            "fax_number": "787-259-1266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ - ORTIZ",
        "first_name": "ALFONSO",
        "middle_name": "ANTONIO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2013-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PR",
            "license": "8745",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PR",
            "license": "8745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.