NPIMap

Individual provider Active NPI

Philip Edward Otterbeck, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Staten Island, NY
National Provider Identifier
1831386424
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
252426 Issued in NY
Practice address
322 Seaview Ave
Staten Island, NY 10305-2246
Phone
(718) 226-3340
Fax
(718) 954-8962
NPI assigned
Sep 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 252426 NY Primary

Addresses

Primary practice location

322 Seaview Ave
Staten Island, NY 10305-2246

Mailing address

322 Seaview Ave
Staten Island, NY 10305-2246
Phone (718) 226-3340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20091014000027 NY Practitioner - EndocrinologyPractitioner - Internal Medicine 9032255567 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Amboy Medical Practice PCGroup PAC ID 2860538170, 171 clinicians

Practice addresses (Care Compare)

Staten Island, NY 10301
Phone (718) 818-1234

2 Teleport Dr
Suite 207
Staten Island, NY 10311-1004
Phone (718) 273-5500

355 Bard Ave
Staten Island, NY 10310-1664

4360 Hylan Blvd
Staten Island, NY 10312-6533
Phone (718) 818-5000

4434 Amboy Rd
Staten Island, NY 10312-3845
Phone (718) 984-9658

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Amboy Medical Practice PC CurrentSince Dec 1, 2012 Accepting new patients
Amboy Medical Practice PC CurrentSince Dec 1, 2012 Accepting new patients
University Physicians Group P C Endocrinology, Diabetes & Metabolism Past Accepting new patients
LMC Physician Services, PC Past Accepting new patients

Locations

4434 Amboy Rd
Staten Island, NY 10312
Phone (718) 818-1015

1366 Victory Blvd
Ste A
Staten Island, NY 10301
Phone (718) 727-1366

355 Bard Ave
Staten Island, NY 10310
Phone (718) 818-1380

Networks

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

Interoperability endpoints

  • Direct secure messaging: potterbeck65371@northwell.direct-ci.com
  • Direct secure messaging: philip.otterbeck.1@19656.direct.athenahealth.com

Organizations & group practices 4

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 9

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": "1190851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1831386424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 SEAVIEW AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103052246",
            "telephone_number": "718-226-3340",
            "fax_number": "718-954-8962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 SEAVIEW AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103052246",
            "telephone_number": "718-226-3340",
            "fax_number": "718-954-8962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTERBECK",
        "first_name": "PHILIP",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-27",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "252426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.