Individual provider Active NPI

Daniella Otaiza, F.N.P

  • Psychiatric/Mental Health Nurse Practitioner
  • Staten Island, NY
National Provider Identifier
1003248535
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
405719 Issued in NY
Practice address
5 Little Clove Rd
Staten Island, NY 10301-4304
Phone
(718) 876-9600
Fax
(718) 876-7773
NPI assigned
Aug 7, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 405719 NY Primary
Family Nurse Practitioner 363LF0000X 338216 NY

Addresses

Primary practice location

5 Little Clove Rd
Staten Island, NY 10301-4304

Mailing address

5 Little Clove Rd
Staten Island, NY 10301-4304
Phone (718) 876-9600

Other practice location 1

80 5th Ave Ste 903-10
New York, NY 10011-8002
Phone (347) 707-7735

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250822001073 NY Practitioner - Nurse Practitioner 7113427337 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

375 Seguine Ave
Staten Island, NY 10309-3932
Phone (718) 226-6902

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Orenda Psychiatry PLLC CurrentSince Jan 2, 2026 Accepting new patients
North Shore-Lij Medical PC CurrentSince Jun 16, 2025 Accepting new patients
North Shore - Lij Medical PC CurrentSince Jun 16, 2025 Accepting new patients

Locations

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

80 5th Ave
Ste 90310
New York, NY 10011

300 Community Dr
Plandome, NY 11030

375 Seguine Ave
Staten Island, NY 10309
Phone (718) 226-2000

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: dotaiza61271@northwell.direct-ci.com
  • Direct secure messaging: daniella.otaiza.1@24989.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1375833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1003248535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 LITTLE CLOVE RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103014304",
            "telephone_number": "718-876-9600",
            "fax_number": "718-876-7773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 LITTLE CLOVE RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103014304",
            "telephone_number": "718-876-9600",
            "fax_number": "718-876-7773"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 5th Ave Ste 903-10",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100118002",
            "country_code": "US",
            "telephone_number": "347-707-7735",
            "fax_number": "347-745-0992",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OTAIZA",
        "first_name": "DANIELLA",
        "credential": "F.N.P",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-07",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "405719",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "338216",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.