Carissa Rhea Ortega, MSN, APRN, CPNP-AC/P

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

94568 Issued in OK

Practice address

1200 Childrens Ave Ste 2F
Oklahoma City, OK 73104-4637

Phone

(405) 271-4411

NPI assigned

Feb 27, 2017

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

Other identifiers 1

Other names 1

• Carissa Declerck Former name

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Board of Regents of the University of Oklahoma - Ou Physicians

  • Multi-Specialty Clinic/Center
  • Oklahoma City, OK
  • NPI 1801869250
  Medicare reassignment NPD
• Ou Health Partners, Inc

  • Multi-Specialty Clinic/Center
  • Oklahoma City, OK
  • NPI 1528642642
  Medicare reassignment NPD
• Board of Regents of the University of Oklahoma - Ou Physicians

  • Multi-Specialty Clinic/Center
  • Edmond, OK
  • NPI 1124646971
  NPD
• Ou Health Partners, Inc

  • Prosthetic/Orthotic Supplier
  • Oklahoma City, OK
  • NPI 1447834460
  NPD
• Ou Medicine Inc.

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1649794157
  NPD (past)

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

{
    "created_epoch": "1488153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1760922678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CHILDRENS AVE # 2F",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731044637",
            "telephone_number": "405-271-4411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 CHILDRENS AVE STE 2F",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731044637",
            "telephone_number": "405-271-4411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13913 N May Ave",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731345035",
            "country_code": "US",
            "telephone_number": "405-757-7818",
            "fax_number": "405-703-0645",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13913 N May Ave",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731345035",
            "country_code": "US",
            "telephone_number": "405-757-7818",
            "fax_number": "405-703-0645",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ORTEGA",
        "first_name": "CARISSA",
        "middle_name": "RHEA",
        "credential": "MSN, APRN, CPNP-AC/P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-27",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OK",
            "license": "94568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200700860B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARISSA",
            "last_name": "DECLERCK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Krysta Ann Orscheln
• James Leo Orsi I, M.S.W.
• Jose Francisco Ortega Tola, MD
• Austin Paul Ortega
• Beatriz Andrea Ortega, CPRSS
• David Ortega, CASE MANAGER
• Erika Ortega, CPRSS
• Ortho Plus Holdings LLC
• Ortho Plus Holdings LLC
• Orthodontic Associates

• Pediatric Nurse Practitioner in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Pediatric Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.