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Shayom Javinish Ortiz

Anesthesiology

Allopathic & Osteopathic Physicians

12222 Merit Dr Ste 600, Dallas, TX 75251-3294

PECOS Enrollment

This provider is enrolled in PECOS as SHAYOM ORTIZ.

Based on the most recent information from CMS, provider Shayom Javinish Ortiz is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 34 days ago.

Profile Details

Provider ID
1184824609
Provider Type
Individual
Full Name
Ortiz, Shayom Javinish
Title
Dr.
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
7/23/2007
Last Updated
8/19/2022

Contact Information

Practice Location

12222 Merit Dr Ste 600, Dallas, TX 75251-3294

(972) 715-5000

(972) 715-9976

Mailing Location

PO Box 840853, Dallas, TX 75284-0853

(972) 715-5000

(972) 715-9976

Provider Taxonomies

Code	Description	License
Code 207L00000X Primary	Description Anesthesiology Allopathic & Osteopathic Physicians	License N3964 Texas

Shayom Javinish Ortiz

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Craig-Mcmurtry, Kelli

Clifton, J Cannon

Gilly, Michael David

Layman, Richard M.

Huss, Michael G.

Odinkemelu, Didi Stephanie

Hoffman, William J.

Rojas, Jesse Allan

Bunker, Noah Stephen

Tsang, Elvis