Active NPI
Alisa D. Ortega, NP
- Pediatric Nurse Practitioner
- Boise, ID
National Provider Identifier
1811184492
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- NP242A
- Practice address
- 417 S 6TH St
Boise, ID 83702-7632 - Phone
- (208) 577-4460
- Fax
- (208) 577-4469
- NPI assigned
- Sep 27, 2007
- Last updated
- Oct 6, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | NP242A | ID | Primary |
Addresses
Primary practice location
417 S 6TH St
Boise, ID 83702-7632
Mailing address
190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-2222
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D93724 | Other | UPIN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NP242A | ID | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349481600000",
"number": "1811184492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "190 E BANNOCK ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837126241",
"telephone_number": "208-381-2222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "417 S 6TH ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837027632",
"telephone_number": "208-577-4460",
"fax_number": "208-577-4469"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ORTEGA",
"first_name": "ALISA",
"middle_name": "D.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-27",
"last_updated": "2012-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "ID",
"license": "NP242A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UPIN",
"identifier": "D93724",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.