Mary Teresa Botelho, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

TUV008583 Issued in NY

Practice address

462 1St Ave
New York, NY 10016-9196

Phone

(212) 562-1394

NPI assigned

Jun 30, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

State University of New York - State College Optometry, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bellevue Hospital Center Hospital, New York, NY, CCN 330204
• Staten Island University Hospital Hospital, Staten Island, NY, CCN 330160

Merit-based Incentive Payment System (MIPS)

Final score

90.8 of 100Reported as group

Quality

91.79

Promoting interoperability

100

Improvement activities

40

Cost

75.18

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mbotelho695699@nychhc.direct-ci.com

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.

• New York University

  • Cardiovascular Disease Physician
  • Boynton Beach, FL
  • NPI 1285826438

  Multi-Specialty, NY

  Medicare reassignment Care Compare group NPD
• Be Well Primary Health Care Center, LLC

  • Multi-Specialty Clinic/Center
  • Brooklyn, NY
  • NPI 1083623409
  Medicare reassignment NPD
• NYU Langone Hospitals

  • Internal Medicine Physician
  • New York, NY
  • NPI 1790975944

  Multi-Specialty

  Medicare reassignment NPD
• State of New York Comptrollers Office

  • Optometrist
  • New York, NY
  • NPI 1407829856
  Medicare reassignment NPD
• NYU Langone Hospitals

  • Psychiatric Hospital Unit
  • Patchogue, NY
  • NPI 1508687021
  NPD
• NYU Langone Hospitals

  • Multi-Specialty Clinic/Center
  • Brooklyn, NY
  • NPI 1831549559
  NPD
• State of New York Comptrollers Office

  • Developmental Disabilities Clinic/Center
  • Staten Island, NY
  • NPI 1750469912

  Multi-Specialty

  NPD
• New York University

  • Physical Medicine & Rehabilitation Physician
  • Boynton Beach, FL
  • NPI 1104787613

  Multi-Specialty

  NPD

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

• New York City Health and Hospitals Corporation

  • General Acute Care Hospital
  • New York, NY
  • NPI 1073535027
  Care Compare affiliation
• Staten Island University Hospital

  • General Acute Care Hospital
  • Staten Island, NY
  • NPI 1407877137
  Care Compare affiliation

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

{
    "created_epoch": "1498780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628467200000",
    "number": "1861913774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 CANNON BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103062811",
            "telephone_number": "718-873-4761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "462 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100169196",
            "telephone_number": "212-562-1394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTELHO",
        "first_name": "MARY",
        "middle_name": "TERESA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-30",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV008583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbotelho273516@nyumc.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "NYU Langone Hospitals",
            "address_1": "150 55th St",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112202559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Laurie Ann Bosworth, PT
• Carolyn Boszak, CRNA
• Dorina Adriana Botas, M.D.
• Fatima Botasheva
• Stephen Thomas Botek, M.D.
• Josue Botello-Escalante
• Lana Boter, MD, PPLC
• Claudia Botero-Mondul, D.D.S
• Cristina Margarita Botero, NP
• Gina P Botero

• Optometrist in New York, NY
• Providers in New York, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.