Otoniel David Puerto, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

MD22859 Issued in ME

Practice address

360 Broadway
Bangor, ME 04401

Phone

(207) 907-1430

Fax

(207) 907-3508

NPI assigned

Oct 4, 2005

Last updated

Feb 3, 2022By 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 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in KY

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

Specialty

Anesthesiology

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Commonwealth Anesthesia, PSCGroup PAC ID 5092627521, 181 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Joseph London Hospital, London, KY, CCN 180011

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 31)

Interoperability endpoints

• Direct secure messaging: opuerto860410@direct-prd.goodhelpconnections.org

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.

• Commonwealth Anesthesia, PSC

  • Anesthesiology Physician
  • Lexington, KY
  • NPI 1437196300
  Medicare reassignment Care Compare group NPD
• Kentucky Anesthesia Group, PSC

  • Anesthesiology Physician
  • Georgetown, KY
  • NPI 1073608634
  Medicare reassignment NPD
• Northstar Anesthesia of Kentucky, PLLC

  • Anesthesiology Physician
  • Louisville, KY
  • NPI 1386938900
  Medicare reassignment NPD
• Triangle Anesthesia Group PSC

  • Anesthesiology Physician
  • Hazard, KY
  • NPI 1124079314
  Medicare reassignment NPD
• Anesthesia & Pain Specialists of Bowling Green PLC

  • Anesthesiology Physician
  • Bowling Green, KY
  • NPI 1548253107
  NPD (past)
• Anesthesiology Medical Services PSC

  • Anesthesiology Physician
  • Owensboro, KY
  • NPI 1144253840
  NPD (past)
• Appalachian Regional Healthcare, Inc.

  • Clinical Pathology/Laboratory Medicine Physician
  • Whitesburg, KY
  • NPI 1417045998
  NPD (past)
• Cumberland Anesthesia Associates, Inc.

  • Anesthesiology Physician
  • Somerset, KY
  • NPI 1124134192
  NPD (past)
• Definitive Medical Solutions, PSC

  • Anesthesiology Physician
  • Corbin, KY
  • NPI 1831207067
  NPD (past)
• Jackson Hospital Corporation

  dba Kentucky River ER, Anesth, Radiology

  • Emergency Medicine Physician
  • Jackson, KY
  • NPI 1679774996

  Anesthesiology

  NPD (past)
• Radiology Inc

  • Diagnostic Radiology Physician
  • Huntington, WV
  • NPI 1457339277
  NPD (past)

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

• Saint Joseph Health System, Inc

  dba CHI Saint Joseph London

  • Rural Acute Care Hospital
  • London, KY
  • NPI 1992701429
  Care Compare affiliation

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1568459667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "C/O ST MARYS HEALTH SYSTEM - PROVIDER ENROLLMENT",
            "address_2": "PO BOX 7291",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042437291",
            "telephone_number": "207-777-8941",
            "fax_number": "207-777-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 BROADWAY",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "04401",
            "telephone_number": "207-907-1430",
            "fax_number": "207-907-3508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUERTO",
        "first_name": "OTONIEL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "ME",
            "license": "MD22859",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "KY",
            "license": "34465",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "KY",
            "license": "34465",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "opuerto860410@direct-prd.goodhelpconnections.org",
            "affiliation": "N",
            "address_1": "360 Broadway",
            "city": "Bangor",
            "state": "ME",
            "country_code": "US",
            "postal_code": "04401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nichole Proulx, LMFT
• Tyler Proulx, DPT
• Timothy F Pruchnic, MD
• Joshua James Prue, PHARMD
• Valerie Prue, OTR/L
• Daniel John Puhlman, PHD, MFT
• Paul R Pultorak, D.O.
• Bethany Purinton
• Una Leanna Purvis, RDH, IPDH
• Paul Franklin Pusey

• Anesthesiology Physician in Bangor, ME
• Providers in Bangor, ME by specialty
• Anesthesiology Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2022; 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.