Individual provider Active NPI

Lawrence E Ota, MD

  • Anesthesiology Physician
  • Culver City, CA
National Provider Identifier
1043631617
Registry record updated Dec 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A119302 Issued in CA
Practice address
3850 Keystone Ave Apt 1
Culver City, CA 90232-3363
Phone
(323) 633-4391
NPI assigned
Dec 26, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A119302 CA Primary

Addresses

Primary practice location

3850 Keystone Ave Apt 1
Culver City, CA 90232-3363

Mailing address

3850 Keystone Ave Apt 1
Culver City, CA 90232-3363
Phone (323) 633-4391

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140626002465 CA Practitioner - Anesthesiology 5092943217 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Anesthesia Service Exchange Medical Group IncGroup PAC ID 9638082530, 106 clinicians

Practice addresses (Care Compare)

3315 Watt Ave
Sacramento, CA 95821-3600
Phone (916) 481-6800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
119302CAMDSocial Worker
A119302CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Anesthesia Service Exchange Medical Group, Inc. Anesthesiology CurrentSince Jul 1, 2014 Accepting new patients
Sacsolano Anesthesia Exchange Medical Group, Inc Anesthesiology Past Accepting new patients

Locations

3315 Watt Ave
Sacramento, CA 95821
Phone (916) 481-0777

Organizations & group practices 2

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": "1388016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388016000000",
    "number": "1043631617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3850 KEYSTONE AVE APT 1",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902323363",
            "telephone_number": "323-633-4391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 KEYSTONE AVE APT 1",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902323363",
            "telephone_number": "323-633-4391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTA",
        "first_name": "LAWRENCE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-26",
        "last_updated": "2013-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A119302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Culver City, CA

Sources for this page

Verify at the official NPI Registry.