Joseph Bottalico, D.O.

Primary specialty

Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X

License

P1969 Issued in TX

Practice address

420 E 6TH St
Suite 202
Odessa, TX 79761-4529

Phone

(432) 582-8757

Fax

(432) 582-8928

NPI assigned

Jan 27, 2006

Last updated

Jan 5, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NJ, TX2 enrollments

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 2

Specialty

Obstetrics/Gynecology

Education

Other, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Inspira Health Network Medical Group PCGroup PAC ID 4880797570, 238 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Inspira Health Network Medical Group, P.C.

  dba Inspira Medical Group

  • Multi-Specialty Clinic/Center
  • Glassboro, NJ
  • NPI 1922177856
  Medicare reassignment Care Compare group NPD
• Shore Memorial Hospital

  dba SMH Professional Services

  • Hematology & Oncology Physician
  • Somers Point, NJ
  • NPI 1689795338

  Obstetrics & Gynecology

  Medicare reassignment NPD
• West Texas Maternal Fetal Medicine Center, LLC

  • Maternal & Fetal Medicine Physician
  • Odessa, TX
  • NPI 1730519331
  NPD (past)

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451952000000",
    "number": "1538130653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4123",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797604123",
            "telephone_number": "432-582-2277",
            "fax_number": "432-333-2802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E 6TH ST",
            "address_2": "SUITE 202",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797614529",
            "telephone_number": "432-582-8757",
            "fax_number": "432-582-8928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTTALICO",
        "first_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2016-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "MB04176800",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "OS005732L",
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "NJ",
            "license": "MB04176800",
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "TX",
            "license": "P1969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8895NO",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2099101",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michel Bolis, MD
• Venkata Pravin Bommisetty, PHARMACIST
• Ashlee Lynn Bonner
• Renuka Borra, M.D.
• Vijay Borra, M.D.
• Kent Andrew Boucher, M.D.
• Brittany Leann Bowen, L.M.T.
• Archie Vernard Bowie II, MD
• Leslie Michelle Boyd, L.A.T
• Franklin Russell Boyles, DDS

• Maternal & Fetal Medicine Physician in Odessa, TX
• Providers in Odessa, TX by specialty
• Maternal & Fetal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.