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CARLOS DAVID ORTEGA M.D.
NPI 1972525269
Surgery in Chicago, IL

Active since July 24, 2006PECOS EnrolledAccepts Medicare Assignment
5140 N CALIFORNIA AVE, SUITE 780, CHICAGO, IL 60625(773) 235-8887(773) 235-8882 Get Directions Write a Review

NPPES record last updated: September 20, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Carlos David Ortega M.d. NPPES

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

CARLOS DAVID ORTEGA M.D. (NPI 1972525269) is an individual surgery provider in Chicago, Illinois, licensed in Illinois (036100042) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Mercy Health System Corp, and maintains a secondary practice location in Downers Grove.

NPPES Registry Identity

NPI1972525269
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameCARLOS DAVID ORTEGACredential: M.D.
Location Address5140 N CALIFORNIA AVE, SUITE 780Chicago, IL 60625-3645
Mailing Address5140 N California Ave, Suite 780Chicago, IL 60625-3645 · (773) 235-8887 · Fax (773) 235-8882
Phone(773) 235-8887
Fax(773) 235-8882
Sole ProprietorNo
Medical School CMSUniversity Of Illinois College Of Med (chi/peor/rock/chm-urb)Graduated 1996
Enumeration DateJuly 24, 2006
Last NPPES UpdateSeptember 20, 2023
NPPES CertifiedSeptember 20, 2023
✔ NPI 1972525269 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in IL · 036100042
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
Also ListedSurgery · Surgical Critical CareTaxonomy 2086S0102X · License 036100042 (IL)
5140 N CALIFORNIA AVE, Chicago, IL 60625
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Secondary Practice Location 1

Location 13825 Highland Ave Ste 303Downers Grove, IL 60515-1562 · Phone (630) 275-7800 · Fax (630) 241-9215

Other Identifiers 4

Other1629966IL · Bcbsil Niess
OtherK26864IL · Individual Medicare Id
Other1630046IL · Bsbsil Bsg
Medicaid036-100042IL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware, MercyCare Health Plans.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

Carlos David Ortega 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 ID1759390131
PECOS Enrollment IDI20090518000302
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 Reassignments

4

Medicare enrollment records show Carlos Ortega reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Advocate Health And Hospitals Corp.
2.9 mi
Cardiovascular Disease
3118 N ASHLAND AVE
Chicago, IL 60657
  • Reassigned Medicare billing, Illinois enrollment
  • 4,870 clinicians in this Medicare group
NPI 1487951711 (773) 880-9722
Endeavor Health Medical Group
6.2 mi
Allergy & Immunology
1000 CENTRAL ST
Evanston, IL 60201
  • Reassigned Medicare billing, Illinois enrollment
  • 4,841 clinicians in this Medicare group
NPI 1497701882 (847) 570-5235
Rockford Health Physicians
69 mi
Multi-Specialty
8201 E RIVERSIDE BLVD
Rockford, IL 61114
  • Reassigned Medicare billing, Illinois enrollment
  • 1,375 clinicians in this Medicare group
NPI 1043242886 (608) 314-2428
Mercy Health System Corporation
84 mi
Multi-Specialty
580 N WASHINGTON ST
Janesville, WI 53548
  • Reassigned Medicare billing, Wisconsin enrollment
  • 1,155 clinicians in this Medicare group
NPI 1598718603 (608) 741-7630

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 2

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.
41 services25 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.
13 services13 patients

Hospital Affiliations CMS Care Compare

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

Mercy Health System Corp

Acute Care Hospitals · Janesville, WI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520066
Location1000 Mineral Point AveJanesville, WI 53548 · Rock County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60625 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
$94.06 typical visit price
range $60.08 – $183.39
Typical copayment $23.51 (range $15.02 – $45.84)
Most-billed visit code 99203
Established Patient
$74.80 typical visit price
range $18.97 – $148.12
Typical copayment $18.70 (range $4.74 – $37.03)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

DR. CHATHUSHKI BANDARA DO
Emergency Medicine
5140 N CALIFORNIA AVE
CHICAGO, IL 60625
Cook County (773) 878-8200
PIERCE MICHAEL PATERAKOS
Internal Medicine
5140 N CALIFORNIA AVE
CHICAGO, IL 60625
Cook County (773) 878-8200
DR. VASEEM QURESHI M.D.
Internal Medicine (Nephrology)
5140 N CALIFORNIA AVE, SUITE 700
CHICAGO, IL 60625
Cook County (773) 784-2101
DR. WASAY HUMAYUN M.D.
Family Medicine
5140 N CALIFORNIA AVE, STE 700
CHICAGO, IL 60625
Cook County (773) 784-2101
DR JOSEPH S KIM DPM
Podiatrist (Foot & Ankle Surgery)
5140 N CALIFORNIA AVE, STE 515
CHICAGO, IL 60625
Cook County (773) 989-1699
DR. MORGAN CLEM DO
Hospitalist
5140 N CALIFORNIA AVE
CHICAGO, IL 60625
Cook County (217) 836-1376
LLOYD QUINN YOUNG
Podiatrist (Foot & Ankle Surgery)
5140 N CALIFORNIA AVE
CHICAGO, IL 60625
Cook County (773) 878-8200
SHANNON SIKKILA N.P.
Nurse Practitioner (Adult Health)
5140 N CALIFORNIA AVE
CHICAGO, IL 60625
Cook County (773) 293-4178

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 Carlos Ortega's NPI number?

The NPI number for Carlos Ortega is 1972525269. It was assigned to this individual provider in the NPPES registry on July 24, 2006.

Where is Carlos Ortega located?

Carlos Ortega practices at 5140 N California Ave Suite 780, Chicago, IL 60625. The listed phone number is (773) 235-8887.

What is Carlos Ortega's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Carlos Ortega enrolled in Medicare?

Yes. Carlos 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.

Which organizations bill Medicare for Carlos Ortega's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Carlos Ortega reassigns Medicare benefits to 4 organizations: Advocate Health And Hospitals Corp. (Chicago, IL), Endeavor Health Medical Group (Evanston, IL), Rockford Health Physicians (Rockford, IL) and Mercy Health System Corporation (Janesville, WI). Each 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 Carlos Ortega's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Carlos Ortega accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and MercyCare Health Plans list Carlos 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.

Is Carlos Ortega affiliated with any hospitals?

According to CMS data, Carlos Ortega is affiliated with Mercy Health System Corp.

When was this NPI record last updated?

The NPPES record for Carlos Ortega was last updated on September 20, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.