Individual provider Active NPI

Paul C Motta, DO

  • Specialist
  • Dothan, AL
National Provider Identifier
1073575924
Registry record updated Apr 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
DO-381 Issued in NY
Practice address
4300 W Main St Ste 403
Dothan, AL 36305-1314
Phone
(334) 671-2855
Fax
(334) 793-1561
NPI assigned
Apr 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X DO-381 NY Primary

Addresses

Primary practice location

4300 W Main St Ste 403
Dothan, AL 36305-1314

Mailing address

4300 W Main St Ste 403
Dothan, AL 36305-1314
Phone (334) 671-2855

Other identifiers 3

IdentifierTypeStateIssuer
030004735OtherALRAILROAD MEDICARE
000008838MedicaidAL
051008838OtherALBCBS AL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20110228000486 AL Practitioner - Allergy/Immunology 1658552450 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
New York College of Osteo Medicine of New York Institute of Technology, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ENT Care PCGroup PAC ID 2567499833, 8 clinicians

Practice addresses (Care Compare)

4300 W Main St
Suite 403
Dothan, AL 36305-1314
Phone (334) 793-4788

Hospital & facility affiliations

  • Wiregrass Medical Center Hospital, Geneva, AL, CCN 011309

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO-381NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
ENT Care PC Specialist CurrentSince Jul 1, 1999 Accepting new patients

Locations

4300 W Main St
Ste 403
Dothan, AL 36305
Phone (334) 793-4788

Networks

  • bcbs alabama network 01A0
  • bcbs alabama network 01G0
  • bcbs alabama network 01B0
  • bcbs alabama network 01E0
  • bcbs alabama network 01H0

Organizations & group practices 1

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": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492560000000",
    "number": "1073575924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 W MAIN ST STE 403",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363051314",
            "telephone_number": "334-671-2855",
            "fax_number": "334-793-1561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 W MAIN ST STE 403",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363051314",
            "telephone_number": "334-671-2855",
            "fax_number": "334-793-1561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOTTA",
        "first_name": "PAUL",
        "middle_name": "C",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2017-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "DO-381",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "030004735",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000008838",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS AL",
            "identifier": "051008838",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.