Kyle Otto, RPAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

012448 Issued in NY

Practice address

259 1St St
Mineola, NY 11501-3957

Phone

(516) 663-8312

Fax

(516) 663-2184

NPI assigned

Apr 10, 2008

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

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

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 and National Provider Directory roles.

• Healthquest Health Center LLC

  • Multi-Specialty Clinic/Center
  • Brooklyn, NY
  • NPI 1982376075
  Medicare reassignment
• Olaf Butchma DO PC

  • Internal Medicine Physician
  • Flushing, NY
  • NPI 1164054524
  Medicare reassignment
• Mid Island Medical Associates, PLLC

  • Internal Medicine Physician
  • Center Moriches, NY
  • NPI 1023905247
  NPD (past)
• MM Medical Service PC

  • Specialist
  • Forest Hills, NY
  • NPI 1104281286
  NPD (past)

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

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207785600000",
    "number": "1396918397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 HICKSVILLE RD",
            "address_2": "SUITE 204",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117143471",
            "telephone_number": "516-576-6106",
            "fax_number": "516-576-5801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 1ST ST",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115013957",
            "telephone_number": "516-663-8312",
            "fax_number": "516-663-2184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTO",
        "first_name": "KYLE",
        "credential": "RPAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-10",
        "last_updated": "2008-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "012448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Ortiz, MD, MPH
• Danilo Antonio Ortiz, LCSW
• James Osei-Sarpong Jr., MD
• Keith Oshan, M.D.
• Hashim H Othman, PH.D
• Joshua Oventhal, PA-C
• Saul Oviedo, LPN
• Bonnie E Owens, LCSW-R
• Derya Ozkok, M.D.
• Goldie Pacht

• Physician Assistant in Mineola, NY
• Providers in Mineola, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; 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.