Provider Demographics
NPI:1790724714
Name:ORTEGA, LUIS M (MD)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:M
Last Name:ORTEGA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:320 E NORTH AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4756
Mailing Address - Country:US
Mailing Address - Phone:412-359-3319
Mailing Address - Fax:412-359-4136
Practice Address - Street 1:320 E NORTH AVE FL 4
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4756
Practice Address - Country:US
Practice Address - Phone:412-359-3319
Practice Address - Fax:412-359-4136
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2020-10-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD443694207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102639396Medicaid
PA228052Medicare PIN
FL44208VMedicare Oscar/Certification
FL44208OtherBCBS
FLP00098104OtherMEDICARE RAILROAD