Individual provider Active NPI

Adriana Otto, M.D.

  • Hospitalist Physician
  • Winter Park, FL
National Provider Identifier
1689650723
Registry record updated Jan 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
ME76007 Issued in FL
Practice address
1400 S Orlando Ave
Ste 205
Winter Park, FL 32789-5543
Phone
(407) 644-4053
Fax
(407) 644-4930
NPI assigned
Dec 20, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X ME76007 FL Primary

Addresses

Primary practice location

1400 S Orlando Ave
Ste 205
Winter Park, FL 32789-5543

Mailing address

1400 S Orlando Ave
Ste 205
Winter Park, FL 32789-5543
Phone (407) 644-4053

Other identifiers 1

IdentifierTypeStateIssuer
256622200MedicaidFL

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040528000233 FL Practitioner - Internal Medicine 3274514815

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
David Mazer,M.D.,P.a. Hospitalist Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263427200000",
    "number": "1689650723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 S ORLANDO AVE",
            "address_2": "STE 205",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327895543",
            "telephone_number": "407-644-4053",
            "fax_number": "407-644-4930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S ORLANDO AVE",
            "address_2": "STE 205",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327895543",
            "telephone_number": "407-644-4053",
            "fax_number": "407-644-4930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTO",
        "first_name": "ADRIANA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-20",
        "last_updated": "2010-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME76007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256622200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.