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OLIVIA T ORTIZ M.D.
NPI 1225191992
Internal Medicine - Infectious Disease in Toms River, NJ

Active since December 17, 2006PECOS EnrolledAccepts Medicare Assignment
32.01/100
CMS Quality Rating
1163 ROUTE 37 W, SUITE A1, TOMS RIVER, NJ 08755(732) 505-4007(732) 736-8811 Get Directions Write a Review

NPPES record last updated: May 25, 2017. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Olivia T Ortiz M.d. NPPES

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

OLIVIA T ORTIZ M.D. (NPI 1225191992) is an individual infectious disease provider in Toms River, New Jersey, licensed in New Jersey (25MA07561700) and active in the NPI registry since December 2006. She is enrolled in Medicare PECOS, is affiliated with Community Medical Center, and is a graduate of Other (1984).

NPPES Registry Identity

NPI1225191992
Entity TypeIndividualFemale
Primary Taxonomy207RI0200X
Provider Legal NameOLIVIA T ORTIZCredential: M.D.
Location Address1163 ROUTE 37 W, SUITE A1Toms River, NJ 08755-4973
Mailing Address1163 Route 37 W, Suite A1Toms River, NJ 08755-4973 · (732) 505-4007 · Fax (732) 736-8811
Phone(732) 505-4007
Fax(732) 736-8811
Sole ProprietorYes
Medical School CMSOtherGraduated 1984
Enumeration DateDecember 17, 2006
Last NPPES UpdateMay 25, 2017
✔ NPI 1225191992 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Infectious DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RI0200X
License✔ Licensed in NJ · 25MA07561700
Definition
An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine.
1163 ROUTE 37 W, Toms River, NJ 08755
Open in Google Maps ↗

Other Identifiers 1

Medicare PIN069535

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Olivia T Ortiz M.d. 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 ID6002077492
PECOS Enrollment IDI20120411000583
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.

Medicare Billing Reassignment

Medicare enrollment records show Olivia Ortiz reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Olivia T. Ortiz MD PA
Same address
Infectious Disease
1163 ROUTE 37 W, SUITE A-1
Toms River, NJ 08755
  • Reassigned Medicare billing, New Jersey enrollment
  • 5 clinicians in this Medicare group
NPI 1578725073 (732) 505-4007

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 7

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
1,016 services398 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.
766 services651 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.
77 services44 patients
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.
61 services40 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
37 services37 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
24 services20 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Community Medical Center

Acute Care Hospitals · Toms River, NJ
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310041
Location99 Rt 37 WestToms River, NJ 08755 · Ocean County
Emergency services Birthing friendly

Monmouth Medical Center-Southern Campus

Acute Care Hospitals · Lakewood, NJ
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310084
Location600 River AveLakewood, NJ 08701 · Ocean County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 08755 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$140.34 typical visit price
range $61.59 – $185.05
Typical copayment $35.08 (range $15.39 – $46.26)
Most-billed visit code 99204
Established Patient
$107.94 typical visit price
range $20.08 – $150.98
Typical copayment $26.98 (range $5.02 – $37.74)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

32.01/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality41.2
Improvement Activities0
Cost35.09

Reported Quality Measures

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.
4%526 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.
100%24 patients5/55-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.
7%151 patients1/55-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.
7%236 patients1/55-star benchmark: 100%
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…
5%261 patients1/55-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…
7%236 patients1/55-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.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
1 supplier18 claims18 services$185.60 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 16

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

ADVANCED DIAGNOSTIC AND PSYCHIATRIC THERAPY, PA
Specialist
1163 ROUTE 37 W, BUILDING C SUITE 1
TOMS RIVER, NJ 08755
Ocean County (732) 244-4807
DR. ROBERT BRUCE KANE D.M.D
Dentist (Periodontics)
1163 ROUTE 37 W, SUITE C-4
TOMS RIVER, NJ 08755
Ocean County (732) 244-3800
MISS PAULA T IMAI APRN-BC, CDE
Internal Medicine (Endocrinology, Diabetes & Metabolism)
1163 ROUTE 37 W, SUITE A-1
TOMS RIVER, NJ 08755
Ocean County (732) 736-1000
OSCAR T. ORTIZ, M.D.,P.C.
Internal Medicine (Endocrinology, Diabetes & Metabolism)
1163 ROUTE 37 W, SUITE A-1
TOMS RIVER, NJ 08755
Ocean County (732) 736-1000
DR. MYRA J MARSHALL PH.D.
Counselor (Professional)
1163 ROUTE 37 W, BUILDING C SUITE 1
TOMS RIVER, NJ 08755
Ocean County (732) 581-0504
RONALD P. SINACK
Physiological Laboratory
1163 ROUTE 37 W, SUITE C2
TOMS RIVER, NJ 08755
Ocean County (848) 333-5063
DR. EUGENIA T BABIAK MD
Internal Medicine (Pulmonary Disease)
1163 ROUTE 37 W, D3
TOMS RIVER, NJ 08755
Ocean County (732) 505-0100
OLIVIA T. ORTIZ MD PA
Internal Medicine (Infectious Disease)
1163 ROUTE 37 W, SUITE A-1
TOMS RIVER, NJ 08755
Ocean County (732) 505-4007

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 Olivia Ortiz's NPI number?

The NPI number for Olivia Ortiz is 1225191992. It was assigned to this individual provider in the NPPES registry on December 17, 2006.

Where is Olivia Ortiz located?

Olivia Ortiz practices at 1163 Route 37 W Suite A1, Toms River, NJ 08755. The listed phone number is (732) 505-4007.

What is Olivia Ortiz's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Infectious Disease, with taxonomy code 207RI0200X.

Is Olivia Ortiz enrolled in Medicare?

Yes. Olivia Ortiz 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.

Which organization bills Medicare for Olivia Ortiz's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Olivia Ortiz reassigns Medicare benefits to Olivia T. Ortiz MD PA (Toms River, NJ). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Olivia Ortiz's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Olivia Ortiz accept?

Health plans from Oscar Health list Olivia Ortiz 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.

Is Olivia Ortiz affiliated with any hospitals?

According to CMS data, Olivia Ortiz is affiliated with Community Medical Center and Monmouth Medical Center-Southern Campus.

When was this NPI record last updated?

The NPPES record for Olivia Ortiz was last updated on May 25, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.