Provider Demographics
NPI:1235156118
Name:VISAYA, ORVIN PATRICK OCHOA (MD)
Entity Type:Individual
Prefix:
First Name:ORVIN
Middle Name:PATRICK OCHOA
Last Name:VISAYA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6200 SHINGLE CREEK PKWY
Mailing Address - Street 2:SUITE 260
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55430-2128
Mailing Address - Country:US
Mailing Address - Phone:763-561-5349
Mailing Address - Fax:
Practice Address - Street 1:6200 SHINGLE CREEK PKWY
Practice Address - Street 2:SUITE 250
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55430-2128
Practice Address - Country:US
Practice Address - Phone:763-544-0696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN37776207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN09D85VIOtherBLUE CROSS BLUE SHIELD MI
MN3100070OtherMEDICA
MN360764000Medicaid
MN112438C028OtherUCARE
MN1020875OtherPREFERRED ONE
WI32196200Medicaid
MN847870OtherAMERICA'S PPO
MNHP28541OtherHEALTHPARTNERS
MN09D85VIOtherBLUE CROSS BLUE SHIELD MI
MN847870OtherAMERICA'S PPO
MN390000227Medicare PIN