Individual provider Active NPI

Martin Gerard Ottolini, MD

  • Pediatric Infectious Diseases Physician
  • Bethesda, MD
National Provider Identifier
1407875313
Registry record updated Feb 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Infectious Diseases PhysicianTaxonomy code 2080P0208X
License
4301405308-1036859 Issued in MI
Practice address
4301 Jones Bridge Rd
Bethesda, MD 20814-4712
Phone
(301) 295-3665
Fax
(301) 295-1812
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Infectious Diseases Physician 2080P0208X 4301405308-1036859 MI Primary

Addresses

Primary practice location

4301 Jones Bridge Rd
Bethesda, MD 20814-4712

Mailing address

5600 Griffith Rd
Gaithersburg, MD 20882-2025
Phone (301) 295-3665

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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

Enrollment IDStateProvider typePAC IDDetails
I20140407001086 DC Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 8729210778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301405308-1036859MIMDPediatric Infectious Diseases Physician

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360022400000",
    "number": "1407875313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5600 GRIFFITH RD",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208822025",
            "telephone_number": "301-295-3665",
            "fax_number": "301-295-1812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 JONES BRIDGE RD",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208144712",
            "telephone_number": "301-295-3665",
            "fax_number": "301-295-1812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTOLINI",
        "first_name": "MARTIN",
        "middle_name": "GERARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2013-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "MI",
            "license": "4301405308-1036859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

Verify at the official NPI Registry.