DR. PAULA ANDREA ORTIZ M.D.
NPI 1619358124
Internal Medicine in West Haven, CT

Q: What is Paula Ortiz's NPI number?

The NPI number for Paula Ortiz is 1619358124. It was assigned to this individual provider in the NPPES registry on June 11, 2015.

Q: What is Paula Ortiz's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Paula Ortiz was last updated on February 29, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since June 11, 2015PECOS EnrolledAccepts Medicare Assignment

90.74/100

CMS Quality Rating

1 CELLINI PL STE 102, WEST HAVEN, CT 06516(039) 326-4812(203) 932-4051 Get Directions Write a Review

NPPES record last updated: February 29, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 8, 2023, Nov 23, 2021, Jul 6, 2018 (3 updates tracked since 2018).

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About Dr. Paula Andrea Ortiz M.d. NPPES

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

DR. PAULA ANDREA ORTIZ M.D. (NPI 1619358124) is an individual internal medicine provider in West Haven, Connecticut, licensed in Connecticut (61416) and active in the NPI registry since June 2015. She is enrolled in Medicare PECOS and is a graduate of State University Of Ny Upstate Medical University (2015).

NPPES Registry Identity

NPI1619358124

Entity TypeIndividualFemale

Primary Taxonomy207R00000X

Provider Legal NameDR. PAULA ANDREA ORTIZCredential: M.D.

Location Address1 CELLINI PL STE 102West Haven, CT 06516-1666

Mailing Address1 Cellini Pl Ste 102West Haven, CT 06516-1666 · (220) 932-6481 · Fax (203) 932-4051

Phone(039) 326-4812

Fax(203) 932-4051

Sole ProprietorNo

Medical School CMSState University Of Ny Upstate Medical UniversityGraduated 2015

Enumeration DateJune 11, 2015

Last NPPES UpdateFebruary 29, 20243 updates tracked since enumeration

NPPES CertifiedFebruary 29, 2024

✔ NPI 1619358124 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in CT · 61416

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

1 CELLINI PL STE 102, West Haven, CT 06516

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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

Dr. Paula Andrea 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 ID840547790

PECOS Enrollment IDI20180724000288

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 5

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 nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

604 services239 patients

Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more 99306

An initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.

199 services186 patients

Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes 99305

An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.

94 services91 patients

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

78 services72 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

16 services16 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06516 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

$138.84 typical visit price

range $60.82 – $183.10

Typical copayment $34.71 (range $15.20 – $45.77)

Most-billed visit code 99204

Established Patient

$106.68 typical visit price

range $19.76 – $149.26

Typical copayment $26.67 (range $4.94 – $37.31)

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.

90.74/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

82.27

Promoting Interoperability

100

Improvement Activities

Cost

58.92

Reported Quality Measures

Breast Cancer Screening

62%273 patients3/55-star benchmark: 93%

Cervical Cancer Screening

37%528 patients2/55-star benchmark: 98%

Closing the Referral Loop: Receipt of Specialist Report

29%509 patients2/55-star benchmark: 87%

Colorectal Cancer Screening

65%544 patients3/55-star benchmark: 88%

Controlling High Blood Pressure

66%395 patients3/55-star benchmark: 91%

Diabetes: Eye Exam

33%178 patients2/55-star benchmark: 100%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

16%178 patients4/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

95%2,038 patients4/55-star benchmark: 100%

e-Prescribing

100%246 patients5/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

44%199 patients2/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

61%1,034 patients3/55-star benchmark: 98%

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

53%723 patients3/55-star benchmark: 97%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

40%1,085 patients3/55-star benchmark: 61%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients combinedPopulations: 69% · 1,021 patients

Patients screened: 74% · 1,021 patients

65%148 patients3/55-star benchmark: 100%

Provide Patients Electronic Access to Their Health Information

90%141 patients4/55-star benchmark: 100%

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

80%248 patients4/55-star benchmark: 91%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 0% · 217 patients

Patients totalRate: 10% · 221 patients

11%221 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.

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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.

KATELYN BARON ACNP

Nurse Practitioner (Adult Health)