Individual provider Active NPI

Erica Otoo, OD

  • Optometrist
  • New York, NY
National Provider Identifier
1508029216
Registry record updated Jul 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV0072671 Issued in NY
Practice address
167 Lenox Ave
New York, NY 10026-1320
Phone
(212) 222-6100
Fax
(212) 222-6606
NPI assigned
Jul 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV0072671 NY Primary

Addresses

Primary practice location

167 Lenox Ave
New York, NY 10026-1320

Mailing address

832 Courlandt Avenue
Apartment 2
Bronx, NY 10451
Phone (212) 222-6100

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100104000588 NY Practitioner - Optometry 0547301210 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV0072671NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Nov 15, 2013 Accepting new patients
Montefiore Medical Center CurrentSince Nov 15, 2013 Accepting new patients
See & Style of Bronx Inc. Optometrist CurrentSince Jul 1, 2020 Accepting new patients
Montefiore Medical Center PastSince Mar 22, 2020 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

1619 Boston Rd
Bronx, NY 10460
Phone (718) 589-1590

250 Thurman Munson Way
Rm 236
Bronx, NY 10451
Phone (718) 401-6483

390 E Fordham Rd
Bronx, NY 10458
Phone (718) 220-6060

100 Corporate Dr
#100
Yonkers, NY 10701

Interoperability endpoints

  • Direct secure messaging: eotoo@montefioredirect.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215043200000",
    "number": "1508029216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "832 COURLANDT AVENUE",
            "address_2": "APARTMENT 2",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10451",
            "telephone_number": "212-222-6100",
            "fax_number": "212-222-6606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 LENOX AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100261320",
            "telephone_number": "212-222-6100",
            "fax_number": "212-222-6606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTOO",
        "first_name": "ERICA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-03",
        "last_updated": "2008-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV0072671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.