Fernando R Otero, MD

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

G54054 Issued in CA

Practice address

2637 Shadelands Dr
Walnut Creek, CA 94598-2512

Phone

(925) 932-6330

Fax

(925) 932-0139

NPI assigned

Jun 9, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Merit-based Incentive Payment System (MIPS)

Final score

90.98 of 100Reported as apm

Quality

80.39

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• John Muir Trauma Physicians Billing Service

  • Hospitalist Physician
  • Walnut Creek, CA
  • NPI 1093864837
  Medicare reassignment NPD
• Shadelands Endovascular, LLC

  • Ambulatory Surgical Clinic/Center
  • Walnut Creek, CA
  • NPI 1245620954
  Medicare reassignment NPD
• John Muir Trauma Physicians Billing Service

  • Trauma Surgery Physician
  • Walnut Creek, CA
  • NPI 1962551861
  NPD
• Bass Medical Group

  • Specialist
  • Walnut Creek, CA
  • NPI 1154401941
  NPD (past)

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1346244183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2637 SHADELANDS DR",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982512",
            "telephone_number": "925-932-6330",
            "fax_number": "925-932-0139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2637 SHADELANDS DR",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982512",
            "telephone_number": "925-932-6330",
            "fax_number": "925-932-0139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTERO",
        "first_name": "FERNANDO",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "G54054",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "G54054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Ostrander
• Shasta J Ostrander
• Obinna Osuka, BS
• Douglas Michael Ota, RPH
• Jill Otani, O.T.
• Cianelle-Alexa Ott
• Joshua Otte
• Brooke Otterson, PSYD
• Eric Ottey, MD
• Andrew Otto, M.D.

• Vascular Surgery Physician in Walnut Creek, CA
• Providers in Walnut Creek, CA by specialty
• Vascular Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2020; 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.