Charles Daniel Otero, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

93-PA01 Issued in NM

Practice address

701 Arizona St
Suite a
Clovis, NM 88101-2110

Phone

(575) 742-3033

Fax

(575) 742-1133

NPI assigned

Jun 15, 2006

Last updated

Dec 27, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NM

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

Physician Assistant

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Plains Regional Medical Center Hospital, Clovis, NM, CCN 320022

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Sonmade Wellness, P.C.

  • Primary Care Clinic/Center
  • Clovis, NM
  • NPI 1710571427
  NPD Authorized official
• Trinity Family Medicine, P. C.

  • Family Medicine Physician
  • Clovis, NM
  • NPI 1437264447
  Medicare reassignment
• H. Kyle Sheets MD PA

  • Family Medicine Physician
  • Farwell, TX
  • NPI 1760671697
  NPD (past)

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

• Presbyterian Healthcare Services

  dba Plains Regional Medical Center

  • Rural Acute Care Hospital
  • Clovis, NM
  • NPI 1629053509
  Care Compare affiliation

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482796800000",
    "number": "1255375903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 ARIZONA ST",
            "address_2": "SUITE A",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881012110",
            "telephone_number": "575-742-3033",
            "fax_number": "575-742-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 ARIZONA ST",
            "address_2": "SUITE A",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881012110",
            "telephone_number": "575-742-3033",
            "fax_number": "575-742-1133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTERO",
        "first_name": "CHARLES",
        "middle_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2016-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "93-PA01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "97903",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lindsay E Osborn
• Jennifer Osborne
• Cindy Kay Osburn, CCC SLP
• Wisdom Osisioma, DDS, MPH
• Kendall Osman
• Ahmad H Othman, M.D.
• Alexandra Otis
• Outside the Box Therapy, LLC (Outside The Box Therapy)
• Valencia R Owens
• James Joseph Padilla

• Physician Assistant in Clovis, NM
• Providers in Clovis, NM by specialty
• Physician Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2016; 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.