NPIMap

Individual provider Active NPI

Jesse Ernest Otero, M.D., PH.D.

  • Orthopaedic Surgery Physician
  • Charlotte, NC
National Provider Identifier
1821381674
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
2016-00057 Issued in NC
Practice address
2001 Vail Ave Ste 200
Charlotte, NC 28207-1222
Phone
(704) 323-2564
Fax
(704) 323-3792
NPI assigned
May 25, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 2016-00057 NC Primary

Addresses

Primary practice location

2001 Vail Ave Ste 200
Charlotte, NC 28207-1222

Mailing address

4601 Park Rd Ste 300
Charlotte, NC 28209-2290
Phone (704) 323-2237

Other identifiers 2

IdentifierTypeStateIssuer
1821381674MedicaidNC
NC2694MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160518000114 NC Practitioner - Orthopedic Surgery 8628218914 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Washington University School of Medicine, 2011
Medicare assignment
May accept Medicare assignment
Group practices
OrthocarolinaGroup PAC ID 2062316821, 288 clinicians
Proactive Therapy of North Carolina IncGroup PAC ID 6305753120, shared by 5 NPIs, 540 clinicians
Comprehab, IncGroup PAC ID 2769653757, 376 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

2001 Vail Ave
Suite 200
Charlotte, NC 28207-1219
Phone (704) 323-2000

201 McCullough Dr
Charlotte, NC 28262-3577
Phone (704) 547-1129

2675 Court Dr
Gastonia, NC 28054-1478
Phone (704) 824-7800

2701 Pickett Rd
Durham, NC 27705-5688
Phone (919) 419-9600

320 Jake Alexander Blvd W
Salisbury, NC 28147-1442
Phone (704) 636-0052

7482 Waterside Crossing Blvd
Denver, NC 28037-3006
Phone (704) 827-0598

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement57
Knee replacement115
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Medical Center Orthopaedic Surgery CurrentSince Aug 1, 2021 Accepting new patients
Carolinas Medical Center Current Accepting new patients
Carolinas Medical Center CurrentSince Aug 1, 2021 Accepting new patients
Triad Radiology Associates PLLC Past Accepting new patients
Orthocarolina Orthopaedic Surgery Past Accepting new patients

Locations

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

2001 Vail Ave
Ste 200
Charlotte, NC 28207
Phone (704) 323-2564

Organizations & group practices 7

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.

Hospital & facility affiliations 10

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

NPI Registry JSON

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

{
    "created_epoch": "1306281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1821381674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 PARK RD STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282092290",
            "telephone_number": "704-323-2237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 VAIL AVE STE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071222",
            "telephone_number": "704-323-2564",
            "fax_number": "704-323-3792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTERO",
        "first_name": "JESSE",
        "middle_name": "ERNEST",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-25",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": "2016-00057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1821381674",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NC2694",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.