Individual provider Active NPI

Jose Miguel Otero, M.D

  • Anesthesiology Physician
  • Elizabeth, NJ
National Provider Identifier
1194099887
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MA09833100 Issued in NJ
Practice address
225 Williamson St
Elizabeth, NJ 07202-3625
Phone
(908) 994-5204
NPI assigned
Feb 28, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X 25MA09833100 NJ Primary

Addresses

Primary practice location

225 Williamson St
Elizabeth, NJ 07202-3625

Mailing address

60 Mount Prospect Ave
Belleville, NJ 07109-2078
Phone (201) 755-2235

Other practice location 1

185 S Orange Ave Rm E538
Newark, NJ 07103-2757
Phone (973) 972-5006 ext. 5255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160615001651 NJ Practitioner - Anesthesiology 7214231141 Reassigns benefits to 1 organization
I20220311001185 NY Practitioner - Anesthesiology 7214231141 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore - Lij Anesthesiology, PCGroup PAC ID 1153602453, 990 clinicians

Practice addresses (Care Compare)

160 N Midland Ave
Nyack, NY 10960-1912
Phone (845) 348-2862

195 E Main St
Huntington, NY 11743-2957
Phone (914) 666-8866

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Anesthesiology, PC Single Specialty CurrentSince Jan 18, 2022 Accepting new patients
Garden State Cardiovascular Specialists P.C Single Specialty CurrentSince May 1, 2021 Accepting new patients

Locations

520 N Wood Ave
Linden, NJ 07036
Phone (908) 587-1330

635 Market St
Newark, NJ 07105
Phone (201) 952-6520

195 E Main St
Huntington, NY 11743
Phone (631) 385-8677

Networks

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

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": "1330387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1194099887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 MOUNT PROSPECT AVE",
            "city": "BELLEVILLE",
            "state": "NJ",
            "postal_code": "071092078",
            "telephone_number": "201-755-2235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 WILLIAMSON ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072023625",
            "telephone_number": "908-994-5204"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "185 S Orange Ave Rm E538",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071032757",
            "country_code": "US",
            "telephone_number": "973-972-5006 x5255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OTERO",
        "first_name": "JOSE",
        "middle_name": "MIGUEL",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA09833100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth, NJ

Sources for this page

Verify at the official NPI Registry.