Individual provider Active NPI

Nada Otasevic

  • Registered Nurse
  • Astoria, NY
National Provider Identifier
1174279384
Registry record updated Feb 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
802170 Issued in NY
Practice address
4213 28TH Ave Apt E4
Astoria, NY 11103-2838
Phone
(917) 833-0476
NPI assigned
Feb 25, 2022
Last updated
Feb 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 802170 NY Primary

Addresses

Primary practice location

4213 28TH Ave Apt E4
Astoria, NY 11103-2838

Mailing address

4213 28TH Ave Apt E4
Astoria, NY 11103-2838
Phone (917) 833-0476

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
802170NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1645747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645747200000",
    "number": "1174279384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4213 28TH AVE APT E4",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111032838",
            "telephone_number": "917-833-0476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4213 28TH AVE APT E4",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111032838",
            "telephone_number": "917-833-0476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTASEVIC",
        "first_name": "NADA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-25",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "802170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.