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GILBERT R ORTEGA MD
NPI 1114960168
Orthopaedic Surgery - Orthopaedic Trauma in Scottsdale, AZ

Active since June 14, 2006PECOS EnrolledAccepts Medicare Assignment
3501 N SCOTTSDALE RD, SUITE 142, SCOTTSDALE, AZ 85251(480) 874-2040(480) 874-2041 Get Directions Write a Review

NPPES record last updated: November 16, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Gilbert R Ortega Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GILBERT R ORTEGA MD (NPI 1114960168) is an individual orthopaedic trauma provider in Scottsdale, Arizona, licensed in Arizona (34778) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS and is a graduate of Yale University School Of Medicine (2000).

NPPES Registry Identity

NPI1114960168
Entity TypeIndividualMale
Primary Taxonomy207XX0801X
Provider Legal NameGILBERT R ORTEGACredential: MD
Location Address3501 N SCOTTSDALE RD, SUITE 142Scottsdale, AZ 85251-5648
Mailing AddressPo Box 52457 Dept 3024Phoenix, AZ 85072-2457 · (480) 874-2040 · Fax (480) 874-2041
Phone(480) 874-2040
Fax(480) 874-2041
Sole ProprietorNo
Medical School CMSYale University School Of MedicineGraduated 2000
Enumeration DateJune 14, 2006
Last NPPES UpdateNovember 16, 2007
✔ NPI 1114960168 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic Surgery · Orthopaedic TraumaAllopathic & Osteopathic Physicians
Taxonomy Code207XX0801X
License✔ Licensed in AZ · 34778
Definition
Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic trauma surgeons deal with the evaluation and management of acute orthopaedic injuries, evaluation and treatment of post-traumatic deformities and nonunions, acute and delayed reconstruction of pelvic and acetabular fractures, as well as osteotomy in the adult hip for treatment of hip arthritis.
3501 N SCOTTSDALE RD, Scottsdale, AZ 85251
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Other Identifiers 3

Medicare PINZ110005AZ
Medicare UPINI55089AZ
Medicaid066282AZ

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Arizona, Oscar Health Plan, Inc., UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Gilbert R Ortega Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3173526449
PECOS Enrollment IDI20060808000029
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
119 services83 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
35 services34 patients
New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more 99202
This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.
23 services23 patients
Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221
Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.
21 services21 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
12 services12 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
12 services11 patients

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
100%185 patients5/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
54%888 patients1/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
60%144 patients3/55-star benchmark: 100%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
17%149 patients1/55-star benchmark: 100%
Pain Assessment and Follow-Up
Percentage of visits for patients aged 18 years and older with documentation of a pain assessment using a standardized tool(s) on each visit AND documentation of a follow-up plan when pain is present
89%715 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
92%487 patients4/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
100%185 patients5/55-star benchmark: 95%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
40%429 patients2/55-star benchmark: 100%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
89%487 patients4/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RODNEY SCOTT OWEN MD
Radiology (Diagnostic Radiology)
3501 N SCOTTSDALE RD, SUITE 130
SCOTTSDALE, AZ 85251
Maricopa County (480) 425-5000
CHRISTOPHER CHARLES MAY MD
Radiology (Diagnostic Radiology)
3501 N SCOTTSDALE RD, STE 130
SCOTTSDALE, AZ 85251
Maricopa County (480) 425-5000
WILLIAM HENRY TAYLOR MD PHD
Radiology (Diagnostic Radiology)
3501 N SCOTTSDALE RD, STE 130
SCOTTSDALE, AZ 85251
Maricopa County (480) 425-5000
DR. TOM ALAN WOLVOS MD
Specialist
3501 N SCOTTSDALE RD, STE 234
SCOTTSDALE, AZ 85251
Maricopa County (480) 421-1991
CHRISTOPHER JAMES SALMON MD
Radiology (Diagnostic Radiology)
3501 N SCOTTSDALE RD, STE 130
SCOTTSDALE, AZ 85251
Maricopa County (480) 425-5000
DR. JASON ROLFE KERR M.D.
Radiology (Diagnostic Radiology)
3501 N SCOTTSDALE RD, SUITE 130
SCOTTSDALE, AZ 85251
Maricopa County (480) 425-5000
DR. JARED WHITING ALLEN MD
Radiology (Diagnostic Radiology)
3501 N SCOTTSDALE RD, SUITE 130
SCOTTSDALE, AZ 85251
Maricopa County (480) 425-5000
PAUL WASSERMANN MD
Specialist
3501 N SCOTTSDALE RD, STE 300
SCOTTSDALE, AZ 85251
Maricopa County (480) 949-7808

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gilbert Ortega's NPI number?

The NPI number for Gilbert Ortega is 1114960168. It was assigned to this individual provider in the NPPES registry on June 14, 2006.

Where is Gilbert Ortega located?

Gilbert Ortega practices at 3501 N Scottsdale Rd Suite 142, Scottsdale, AZ 85251. The listed phone number is (480) 874-2040.

What is Gilbert Ortega's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Orthopaedic Trauma, with taxonomy code 207XX0801X.

Is Gilbert Ortega enrolled in Medicare?

Yes. Gilbert Ortega is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Gilbert Ortega accept?

Health plans from Blue Cross Blue Shield of Arizona, Oscar Health Plan, Inc. and UnitedHealthcare list Gilbert Ortega as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Gilbert Ortega was last updated on November 16, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.