Individual provider Active NPI

Lisa Ortiz, MD

  • General Practice Physician
  • San German, PR
National Provider Identifier
1962075424
Registry record updated Jul 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
22395 Issued in PR
Practice address
Bo Ancones Calle Ferrocarril #1
Esquina Gamboa Oficina 3
San German, PR 00683
Phone
(787) 892-3449
NPI assigned
Jul 22, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 22395 PR Primary

Addresses

Primary practice location

Bo Ancones Calle Ferrocarril #1
Esquina Gamboa Oficina 3
San German, PR 00683

Mailing address

Bo Ancones Calle Ferrocarril #1
Esquina Gamboa Oficina 3
San German, PR 00683
Phone (787) 892-3449

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
I20220315001859 PR Practitioner - General Practice 7517352271 Reassigns benefits to 1 organization
Practice locations: San German, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22395PRMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Anesthesia Associates LLC Current Accepting new patients
Hospital Damas Inc CurrentSince Jan 1, 2026 Accepting new patients

Locations

2213 Ponce Byp
Ponce, PR 00717
Phone (787) 368-7802

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1626912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751500800000",
    "number": "1962075424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BO ANCONES CALLE FERROCARRIL #1",
            "address_2": "ESQUINA GAMBOA OFICINA 3",
            "city": "SAN GERMAN",
            "state": "PR",
            "postal_code": "00683",
            "telephone_number": "787-892-3449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BO ANCONES CALLE FERROCARRIL #1",
            "address_2": "ESQUINA GAMBOA OFICINA 3",
            "city": "SAN GERMAN",
            "state": "PR",
            "postal_code": "00683",
            "telephone_number": "787-892-3449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ",
        "first_name": "LISA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-22",
        "last_updated": "2025-07-03",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "22395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San German, PR

Sources for this page

Verify at the official NPI Registry.