Javier Alberto Otero, M.D., PH.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

P79257 Issued in NY

Practice address

205 W 79TH St
Apt #4D
New York, NY 10024-6236

Phone

(917) 674-2202

NPI assigned

Jul 6, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678

Interoperability endpoints

• Direct secure messaging: jotero36492@mskcc.direct-ci.com

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.

• Memorial Pediatric Group

  • Pediatrics Physician
  • New York, NY
  • NPI 1750352381
  Medicare reassignment NPD

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

{
    "created_epoch": "1341532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341532800000",
    "number": "1679838676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 W 79TH ST",
            "address_2": "APT #4D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100246236",
            "telephone_number": "917-674-2202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 W 79TH ST",
            "address_2": "APT #4D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100246236",
            "telephone_number": "917-674-2202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTERO",
        "first_name": "JAVIER",
        "middle_name": "ALBERTO",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-06",
        "last_updated": "2012-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "P79257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gulnar Otchiyeva
• Dennise Elizabeth Otero, M.D.
• Edwin Armando Otero
• Jacqueline Otero, LCSW
• Jade Andrea Otero, MHC
• Jorge Edgardo Otero, M.D.
• Katrina Otero
• Lissette Alexandra Otero, NP
• Marilyn Otero, RPAC
• Lucie M Othoniel, LCSW

• Pediatrics Physician in New York, NY
• Providers in New York, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.