Fredy A Otalora, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC4484 Issued in FL

Practice address

8051 W Sunrise Blvd
Sunrise, FL 33322

Phone

(954) 474-2900

Fax

(954) 474-2901

NPI assigned

Aug 28, 2009

Last updated

Mar 23, 2021By 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eye Physicians of Florida LLPGroup PAC ID 1254414675, 42 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Eye Physicians of Florida LLP

  • Ophthalmology Physician
  • Plantation, FL
  • NPI 1770763799
  Medicare reassignment Care Compare group
• Fort Lauderdale Eye Institute

  • Ophthalmology Physician
  • Plantation, FL
  • NPI 1558475400
  NPD (past)
• South Florida Laser Eye Center

  • Ophthalmology Physician
  • Plantation, FL
  • NPI 1346294113
  NPD (past)

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

{
    "created_epoch": "1251417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1366675043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 39209",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "33339",
            "telephone_number": "954-851-9966",
            "fax_number": "954-318-7360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8051 W SUNRISE BLVD",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "33322",
            "telephone_number": "954-474-2900",
            "fax_number": "954-474-2901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTALORA",
        "first_name": "FREDY",
        "middle_name": "A",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-28",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fredy.otaloraodfaao.p23@direct.eyefl.nextgenshare.com",
            "affiliation": "N",
            "address_1": "8051 W Sunrise Blvd",
            "city": "Sunrise",
            "state": "FL",
            "country_code": "US",
            "postal_code": "33322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Norma Elizabeth Ortiz
• Victor Ortiz, CRNA
• Aton Osbourne, M.D.
• Kelsey Oslan
• Rachel Ostermyer
• Claudia Patricia Otero, D.M.D
• Melissa Denise Otto
• Nethania Tatyana Oxces
• Jonathan Andrew Ozner, D.C
• Lara Elaine Roa Pabalan, PT

• Optometrist in Sunrise, FL
• Providers in Sunrise, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; 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.