MEDICARE: ORVIN PATRICK OCHOA VISAYA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	37776	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	09D85VI	OTHER	MN	BLUE CROSS BLUE SHIELD MI
2	3100070	OTHER	MN	MEDICA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	112438C028	OTHER	MN	UCARE
5	1020875	OTHER	MN	PREFERRED ONE
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	847870	OTHER	MN	AMERICA'S PPO
8	HP28541	OTHER	MN	HEALTHPARTNERS

General Provider Information

NPI Number	:	1235156118
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ORVIN PATRICK OCHOA VISAYA M.D.

Provider Business Mailing Address
First Line	:	6200 SHINGLE CREEK PKWY
Second Line	:	SUITE 260
City	:	BROOKLYN CENTER
State	:	MN
Zip	:	55430-2128
Country	:	US
Telephone Number	:	763-561-5349
Fax Number	:

Provider Business Practice Location Address
First Line	:	6200 SHINGLE CREEK PKWY
Second Line	:	SUITE 250
City	:	BROOKLYN CENTER
State	:	MN
Zip	:	55430-2128
Country	:	US
Telephone Number	:	763-544-0696
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/16/2006
Last Update Date	:	11/10/2020

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