RICARDO M ORTIZ (DMD) – Oral and Maxillofacial Surgery (Dentist), NPI 1497984785
Oral and Maxillofacial Surgery (Dentist)
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for RICARDO M ORTIZ (DMD)
3665 COOLIDGE CT STE 102
TALLAHASSEE, FL 323117894
Phone: (850) 431-6725
Fax: (850) 431-6859
Type: Location
1309, Thomasville Road, Tallahassee, Leon County, Florida, 32303-5458, United States
TALLAHASSEE, FL 323035607
Phone: (850) 431-7021
Type: Mailing
2929, Capital Medical Boulevard, Tallahassee, Leon County, Florida, 32308, United States
TALLAHASSEE, FL 323084407
Phone: (850) 431-6725
Fax: (850) 431-6859
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 9 Open Payments records for all available years, with a total value of $223.
Total Amount is formed as General ($223) + Research ($0) + Ownership ($0) = $223.
Last reported payment date: 2024-11-06 • Largest payer in this snapshot: Straumann USA LLC ($115).
Total Amount
$223
General + Research + Ownership
Payments
9
Total payment records
General Amount
$223
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-06
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2018-03-01
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20180301002287 | I | Maxillofacial Surgery | FL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32311)
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Reviews
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