Individual ProviderStephanie OrtizNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address1102 Barclay St, San Antonio, TX 78207-7161(863) 222-1176PECOS EnrollmentBased on the most recent information from CMS, provider Stephanie Ortiz is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1124799978Provider TypeIndividualFull NameOrtiz, StephanieTitleMs.CredentialFNPGenderFemaleSole ProprietorYesEnumeration Date9/22/2021Last Updated11/29/2023Contact InformationPractice LocationPractice Address1102 Barclay St, San Antonio, TX 78207-7161Phone(863) 222-1176FaxUnlisted FaxMailing LocationMailing Address18810 County Road 5733, Castroville, TX 78009-2202Phone(863) 222-1176FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense1057819TexasCode363LF0000XDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseAPRN11015474Florida