Patrick Thomas Ottuso, M D F A A D

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

ME62353 Issued in FL

Practice address

1955 22ND Ave
Vero Beach, FL 32960-3083

Phone

(772) 299-0085

Fax

(772) 978-4193

NPI assigned

Nov 29, 2005

Last updated

Oct 11, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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.

• Leavitt Medical Associates of Florida Inc

  dba Advanced Dermatology and Cosmetic Surq

  • Dermatology Physician
  • Sebastian, FL
  • NPI 1083872535
  Medicare reassignment NPD
• Patrick T Ottuso M D F a a D P a

  dba vero beach dermatology

  • Dermatology Physician
  • Vero Beach, FL
  • NPI 1124047048
  Authorized official Same address or phone
• Leavitt Medical Associates of Florida Inc

  dba Advanced Dermatology and Cosmetic Sur

  • Dermatology Physician
  • Jupiter, FL
  • NPI 1043478522
  NPD
• Leavitt Medical Associates of Florida Inc

  dba Advanced Dermatology And Cosmetic Surgery

  • Dermatology Physician
  • Heathrow, FL
  • NPI 1528097284
  NPD (past)

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

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192060800000",
    "number": "1386627867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1955 22ND AVE",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329603083",
            "telephone_number": "772-299-0085",
            "fax_number": "772-978-4193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 22ND AVE",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329603083",
            "telephone_number": "772-299-0085",
            "fax_number": "772-978-4193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTUSO",
        "first_name": "PATRICK",
        "middle_name": "THOMAS",
        "credential": "M D F A A D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-29",
        "last_updated": "2007-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME62353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "18397",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "070015813",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "9614490",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Osceola Pharmacy of Vero Beach Inc (Osceola Pharmacy)
• Kathleen Sue Osteen, PTA
• Sheila Ann Osteen
• Abayomi W. Osunkoya, M.D.
• Jose Carlos Otero, D.D.S
• Kimberly J Pace, LCSW
• Linda Padilla
• Yadira Padin-Rojas, MD
• Ryan Padnuk, AP
• Pain Intervention Associates LLC

• Dermatology Physician in Vero Beach, FL
• Providers in Vero Beach, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.