MARIO REMEDIOS ORTIZ PHD; PHCNS-BC, FNP-C
NPI 1265826226
Clinical Nurse Specialist - Community Health/Public Health in South Bend, IN

Active since March 26, 2015PECOS EnrolledAccepts Medicare Assignment
1700 MISHAWAKA AVE # SAC-130, HEALTH & WELLNESS CENTER, IU SOUTH BEND, SOUTH BEND, IN 46615(574) 520-5557(574) 520-5042 Get Directions Write a Review

NPPES record last updated: July 30, 2015. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Mario Remedios Ortiz Phd; Phcns-bc, Fnp-c NPPES

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

MARIO REMEDIOS ORTIZ PHD; PHCNS-BC, FNP-C (NPI 1265826226) is an individual community health/public health provider in South Bend, Indiana, licensed in Indiana (71005395A) and active in the NPI registry since March 2015. He is enrolled in Medicare PECOS and is a graduate of Other (1997).

NPPES Registry Identity

NPI1265826226
Entity TypeIndividualMale
Primary Taxonomy364SC1501X
Provider Legal NameMARIO REMEDIOS ORTIZCredential: PHD; PHCNS-BC, FNP-C
Location Address1700 MISHAWAKA AVE # SAC-130, HEALTH & WELLNESS CENTER, IU SOUTH BENDSouth Bend, IN 46615-1408
Mailing Address1700 Mishawaka Ave # Sac-130, Health & Wellness Center, Iu South BendSouth Bend, IN 46615-1408 · (574) 520-5557 · Fax (574) 520-5042
Fax(574) 520-5042
Sole ProprietorYes
Medical School CMSOtherGraduated 1997
Enumeration DateMarch 26, 2015
Last NPPES UpdateJuly 30, 2015
NPI 1265826226 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyClinical Nurse Specialist · Community Health/Public HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code364SC1501X
License Licensed in IN · 71005395A
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 71005395A (IN)
1700 MISHAWAKA AVE # SAC-130, South Bend, IN 46615

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

Mario Remedios Ortiz Phd; Phcns-bc, Fnp-c 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 ID1153752779
PECOS Enrollment IDI20200515000853
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46615 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
$122.49 typical visit price
range $53.07 – $161.76
Typical copayment $30.62 (range $13.26 – $40.44)
Most-billed visit code 99204
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
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.

Reported Quality Measures

Cervical Cancer Screening
1%67 patients1/55-star benchmark: 98%
Colorectal Cancer Screening
0%35 patients1/55-star benchmark: 88%
Documentation of Current Medications in the Medical Record
100%354 patients5/55-star benchmark: 100%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
100%75 patients5/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients combinedPopulations: 67% · 167 patients
Patients screened: 100% · 167 patients
61%140 patients3/55-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.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1265826226, enumerated as an "individual" on March 26, 2015.

The provider is located at 1700 MISHAWAKA AVE # SAC-130 HEALTH & WELLNESS CENTER, IU SOUTH BEND SOUTH BEND, IN 46615 and the phone number is (574) 520-5557.

Clinical Nurse Specialist with taxonomy code 364SC1501X and a focus in Community Health/Public Health.