Individual provider Active NPI

James A Otis, M.D.

  • Neurology Physician
  • Worcester, MA
National Provider Identifier
1184687618
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
57981 Issued in MA
Practice address
55 Lake Ave N
Worcester, MA 01655-0002
Phone
(508) 421-1401
Fax
(508) 421-1490
NPI assigned
Apr 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 57981 MA Primary

Addresses

Primary practice location

55 Lake Ave N
Worcester, MA 01655-0002

Mailing address

281 Lincoln St
Provider Enrollment
Worcester, MA 01605-2371
Phone (774) 366-9653

Other practice location 1

725 Albany St
Shapiro 7th Floor, Suite 7B
Boston, MA 02118-2526
Phone (617) 638-8456

Other identifiers 1

IdentifierTypeStateIssuer
110047023AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20051029000302 MA Practitioner - Neurology 1456378314 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
New York Medical College, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57981MAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Umass Memorial Medical Group, Inc. CurrentSince Jul 1, 2025 Accepting new patients
Umass Memorial Medical Group Inc Current Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Boston University Neurosurgical Associates, Inc. Past Accepting new patients

Locations

759 Chestnut St
Springfield, MA 01199
Phone (413) 794-3233

281 Lincoln St
Worcester, MA 01605
Phone (508) 334-8015

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

Organizations & group practices 4

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": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1184687618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "281 LINCOLN ST",
            "address_2": "PROVIDER ENROLLMENT",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052371",
            "telephone_number": "774-366-9653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-421-1401",
            "fax_number": "508-421-1490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "725 Albany St",
            "address_2": "Shapiro 7th Floor, Suite 7B",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021182526",
            "country_code": "US",
            "telephone_number": "617-638-8456",
            "fax_number": "617-638-8465",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OTIS",
        "first_name": "JAMES",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-07",
        "last_updated": "2025-07-08",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MA",
            "license": "57981",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110047023A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.