Individual provider Active NPI

Otto R Urbay, FNP-C

  • Family Nurse Practitioner
  • Boynton Beach, FL
National Provider Identifier
1508247537
Registry record updated Mar 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11024713 Issued in FL
Practice address
2240 W Woolbright Rd Ste 210
Boynton Beach, FL 33426-6363
Phone
(800) 348-4565
Fax
(888) 203-4247
NPI assigned
Jun 16, 2015
Last updated
Mar 2, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X
Family Nurse Practitioner 363LF0000X APRN11024713 FL Primary

Addresses

Primary practice location

2240 W Woolbright Rd Ste 210
Boynton Beach, FL 33426-6363

Mailing address

3 Maryland Farms Ste 200
Brentwood, TN 37027-5780
Phone (800) 348-4565

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230314001002 FL Practitioner - Nurse Practitioner 2264806348 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Specialtycare Surgical Assist, LLCGroup PAC ID 3274446497, 33 clinicians

Practice addresses (Care Compare)

11750 SW 40 St
Miami, FL 33175-3530
Phone (305) 223-3000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11024713FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Specialtycare Surgical Assist, LLC CurrentSince Feb 17, 2023 Accepting new patients

Locations

2240 W Woolbright Rd
Ste 210
Boynton Beach, FL 33426
Phone (305) 781-6651

11750 SW 40th St
Miami, FL 33175
Phone (305) 227-5544

3663 S Miami Ave
Miami, FL 33133
Phone (305) 285-2131

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

3 Maryland Farms
Ste 200
Brentwood, TN 37027
Phone (615) 346-8733

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1434412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1508247537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 MARYLAND FARMS STE 200",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275780",
            "telephone_number": "800-348-4565",
            "fax_number": "888-203-4247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 W WOOLBRIGHT RD STE 210",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334266363",
            "telephone_number": "800-348-4565",
            "fax_number": "888-203-4247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URBAY",
        "first_name": "OTTO",
        "middle_name": "R",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-16",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11024713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

Verify at the official NPI Registry.