Individual provider Active NPI

Jose K Otto

  • Licensed Practical Nurse
  • Bronx, NY
National Provider Identifier
1730933300
Registry record updated Apr 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
330261 Issued in NY
Practice address
7 W Burnside Ave FL 2
Bronx, NY 10453-4003
Phone
(212) 243-7070
NPI assigned
Apr 11, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 330261 NY Primary

Addresses

Primary practice location

7 W Burnside Ave FL 2
Bronx, NY 10453-4003

Mailing address

129 S 14TH Ave
Mount Vernon, NY 10550-2811
Phone (914) 351-3845

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

State licenses

LicenseStateTypeSpecialty
330261NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1712793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712966400000",
    "number": "1730933300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 S 14TH AVE",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105502811",
            "telephone_number": "914-351-3845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 W BURNSIDE AVE FL 2",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104534003",
            "telephone_number": "212-243-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTO",
        "first_name": "JOSE",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-11",
        "last_updated": "2024-04-13",
        "certification_date": "2024-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "330261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.