Individual provider Active NPI

Leslie Ortiz, MD

  • General Practice Physician
  • Haines City, FL
National Provider Identifier
1992827000
Registry record updated Jan 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN778 Issued in FL
Practice address
608 Ingraham Ave
Haines City, FL 33844-4330
Phone
(863) 422-9562
Fax
(863) 421-3246
NPI assigned
Apr 6, 2007
Last updated
Jan 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2023

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 ACN778 FL Primary

Addresses

Primary practice location

608 Ingraham Ave
Haines City, FL 33844-4330

Mailing address

PO Box 4189
Deerfield Beach, FL 33442-4189
Phone (954) 363-9582

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20180109001382 FL Practitioner - General Practice 7113155417 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Consultants of Florida LLCGroup PAC ID 6002988847, 35 clinicians

Practice addresses (Care Compare)

608 Ingraham Ave
Haines City, FL 33844-4330
Phone (863) 422-9562

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ACN778FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Consultants of Florida, LLC General Practice CurrentSince Jan 27, 2023 Accepting new patients
Xpress Urgent Care, LLC. General Practice Current Accepting new patients
Medical Home Alliance LLC PastSince Dec 4, 2017 Accepting new patients
Emergenciologos Para Puerto Rico,CSP Past Accepting new patients
Patient Medical Center of Florida Inc General Practice PastSince Apr 4, 2018 Accepting new patients

Locations

175 Patterson Rd
Haines City, FL 33844
Phone (863) 358-4849

608 Ingraham Ave
Haines City, FL 33844
Phone (863) 422-9562

819 N Central Ave
Kissimmee, FL 34741
Phone (407) 288-8242

672 SW Prima Vista Blvd
Ste 101
Port St Lucie, FL 34983
Phone (772) 905-2555

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674777600000",
    "number": "1992827000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4189",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334424189",
            "telephone_number": "954-363-9582",
            "fax_number": "954-363-9663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 INGRAHAM AVE",
            "city": "HAINES CITY",
            "state": "FL",
            "postal_code": "338444330",
            "telephone_number": "863-422-9562",
            "fax_number": "863-421-3246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ",
        "first_name": "LESLIE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2023-01-27",
        "certification_date": "2023-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Haines City, FL

Sources for this page

Verify at the official NPI Registry.