Active NPI
Matheus Lisboa Otero, MD
- Student in an Organized Health Care Education/Training Program
- New York, NY
National Provider Identifier
1558010272
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 281 1St Ave
New York, NY 10003-2925 - Phone
- (212) 844-8888
- Fax
- (212) 844-8481
- NPI assigned
- Mar 21, 2022
- Last updated
- Mar 23, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
281 1St Ave
New York, NY 10003-2925
Mailing address
1 Gustave L Levy PL
Box 1076
New York, NY 10029-6504
Phone (212) 241-6694
Other practice location 1
10 Union Sq E
New York, NY 10003-3314
Phone (212) 844-6000
Other practice location 2
1 Gustave L. Levy Place
New York, NY 10029-6574
Phone (212) 241-6500
Other practice location 3
1000 10th Ave
New York, NY 10019-1147
Phone (212) 523-4000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647993600000",
"number": "1558010272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 GUSTAVE L LEVY PL",
"address_2": "BOX 1076",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100296504",
"telephone_number": "212-241-6694"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "281 1ST AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100032925",
"telephone_number": "212-844-8888",
"fax_number": "212-844-8481"
}
],
"practiceLocations": [
{
"address_1": "10 Union Sq E",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100033314",
"country_code": "US",
"telephone_number": "212-844-6000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1 Gustave L. Levy Place",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100296574",
"country_code": "US",
"telephone_number": "212-241-6500",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1000 10th Ave",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100191147",
"country_code": "US",
"telephone_number": "212-523-4000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LISBOA OTERO",
"first_name": "MATHEUS",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-03-21",
"last_updated": "2022-03-23",
"certification_date": "2022-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.