NPIMap

Organization Active NPI

Ortego Healthcare LLC

  • Rural Health Clinic/Center
  • Opelousas, LA
National Provider Identifier
1750931945
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
ORTEGO HEALTHCARE LLC
Practice address
2949 S Union St
Opelousas, LA 70570-5740
Phone
(337) 948-9606
Fax
(337) 948-7003
NPI assigned
Sep 19, 2019
Last updated
Jun 1, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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

Authorized official

Name
Tim Ortego
Title
Owner
Phone
(337) 948-9606

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary
Family Nurse Practitioner 363LF0000X

Addresses

Primary practice location

2949 S Union St
Opelousas, LA 70570-5740

Mailing address

2949 S Union St
Opelousas, LA 70570-5740
Phone (337) 948-9606

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20200129000333 LA Part B Supplier - Clinic/Group Practice 5496181141 Receives reassigned benefits from 3 practitioners
Practice locations: Opelousas, LA
O20200708003233 LA Part A Provider - Rural Health Clinic 5496181141 Practice locations: Opelousas, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1750931945. Details of each certification follow.

Rural health clinic certification: CCN 193969

Legal name
ORTEGO HEALTHCARE LLC
Doing business as
ORTEGO FAMILY MEDICINE ALLERGY & ASTHMA
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jan 12, 2021
Last certification
Jan 12, 2024
Ownership / control type
1B
Organization structure
LLCProprietary
Incorporated
Aug 21, 2019 in LA
Enrollment address
2949 S Union St
Opelousas, LA 70570-5740

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D0723902Ortego Healthcare, LLC2949 South Union Street, Opelousas, LA 70570Certificate of waiverMar 24, 2028

National Provider Directory

National Provider Directory

Locations

2949 S Union St
Opelousas, LA 70570
Phone (337) 948-9606

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Trina Allemond Ortego Individual 5% Or Greater Direct Ownership InterestOfficer Aug 21, 2019 51%
Corporate OfficerCeo Aug 21, 2019 51%
Timothy J Ortego Individual 5% Or Greater Direct Ownership InterestOfficer Aug 21, 2019 49%
Corporate OfficerCoo Aug 21, 2019 49%
W-2 Managing EmployeeCoo Aug 21, 2019

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1568851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685577600000",
    "number": "1750931945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2949 S UNION ST",
            "city": "OPELOUSAS",
            "state": "LA",
            "postal_code": "705705740",
            "telephone_number": "337-948-9606",
            "fax_number": "337-948-7003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2949 S UNION ST",
            "city": "OPELOUSAS",
            "state": "LA",
            "postal_code": "705705740",
            "telephone_number": "337-948-9606",
            "fax_number": "337-948-7003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTEGO HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-19",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A",
        "authorized_official_last_name": "ORTEGO",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "337-948-9606"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Opelousas, LA

Sources for this page

Verify at the official NPI Registry.