Active NPI
Joseph A Otero, MA
- Speech-Language Pathologist
- Flushing, NY
National Provider Identifier
1790095677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 010601-1
- Practice address
- 14461 Roosevelt Ave
Flushing, NY 11354-6252 - Phone
- (718) 939-8700
- NPI assigned
- Oct 13, 2010
- Last updated
- Oct 13, 2010
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 010601-1 | NY | Primary |
Addresses
Primary practice location
14461 Roosevelt Ave
Flushing, NY 11354-6252
Mailing address
156 67TH St
Brooklyn, NY 11220-4822
Phone (917) 723-4549
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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 010601-1 | NY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Shield of David, Inc. | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1286928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1286928000000",
"number": "1790095677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "156 67TH ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112204822",
"telephone_number": "917-723-4549"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14461 ROOSEVELT AVE",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113546252",
"telephone_number": "718-939-8700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OTERO",
"first_name": "JOSEPH",
"middle_name": "A",
"name_prefix": "Mr.",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-10-13",
"last_updated": "2010-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "010601-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flushing, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.