Juan Gabriel Ortiz-Vazquez, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

125.079321 Issued in IL

Practice address

2160 S 1St Ave BLDG 105
Maywood, IL 60153-3328

Phone

(708) 216-6462

Fax

(708) 216-1249

NPI assigned

Mar 28, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jortizvã¡zquez162329@direct.luhs.org

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.

• Loyola University Medical Center

  • General Acute Care Hospital
  • Maywood, IL
  • NPI 1376521575
  NPD

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

{
    "created_epoch": "1648425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653523200000",
    "number": "1962152231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1342 W CULLERTON ST APT 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606083114",
            "telephone_number": "787-485-0817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE BLDG 105",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-6462",
            "fax_number": "708-216-1249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ-VAZQUEZ",
        "first_name": "JUAN",
        "middle_name": "GABRIEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-28",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "125.079321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathaniel P. Oommen
• Aaron W Oraham, MD
• Julia Organ, MD
• Vanessa Maria Orlando Castellanos
• Lissette Carmen Ortiz-Ferrer, M.D.
• Phillip Anthony Osak
• Lilya Oshana
• Osheay Transportation, Inc
• Thomas Edward Osterholt III, DO
• Rochella Abaygar Ostrowski, M.D.

• Anesthesiology Physician in Maywood, IL
• Providers in Maywood, IL by specialty
• Anesthesiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2022; 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.