Lissette Alexandra Otero, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

311049 Issued in NY

Practice address

4405 Broadway
New York, NY 10040-4014

Phone

(212) 740-2020

Fax

(646) 666-0280

NPI assigned

Feb 2, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Doral Medical and Multi Specialty Facility LLCGroup PAC ID 9830528645, 53 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• VNS of Ny Home Care Chha Home health agency, New York, NY, CCN 337008
• Americare Certified Special Services, Inc Chha Home health agency, Brooklyn, NY, CCN 337290

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Doral Medical and Multi Specialty Facility LLC

  • Multi-Specialty Clinic/Center
  • Brooklyn, NY
  • NPI 1144693607
  Medicare reassignment Care Compare group NPD
• Oak Street Health of New York Medical Group PC

  • Primary Care Clinic/Center
  • Brooklyn, NY
  • NPI 1780209445
  Medicare reassignment NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Americare Certified Special Services, Inc.

  • Home Health Agency
  • Brooklyn, NY
  • NPI 1770513145
  Care Compare affiliation
• Visiting Nurse Service of New York Home Care II

  dba Visiting Nurse Service of New York Home Care

  • Home Health Agency
  • New York, NY
  • NPI 1528059805
  Care Compare affiliation

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

{
    "created_epoch": "1675296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776038400000",
    "number": "1255037065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746087",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746087",
            "telephone_number": "773-352-1515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100404014",
            "telephone_number": "212-740-2020",
            "fax_number": "646-666-0280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "161 E 91st St Apt 4A",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "101282019",
            "country_code": "US",
            "telephone_number": "203-818-3741",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OTERO",
        "first_name": "LISSETTE",
        "middle_name": "ALEXANDRA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-02",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "311049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Otero, LCSW
• Jade Andrea Otero, MHC
• Javier Alberto Otero, M.D., PH.D.
• Jorge Edgardo Otero, M.D.
• Katrina Otero
• Marilyn Otero, RPAC
• Lucie M Othoniel, LCSW
• Emma Otieno, DPM
• Hannah Otiker, PHARMD
• Karen M Otis, LMHC, MA

• Adult Health Nurse Practitioner in New York, NY
• Providers in New York, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.