Riichi Andre Ota, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

36082 Issued in LA

Practice address

971 Lakeland Dr Ste 557
Jackson, MS 39216-4661

Phone

(601) 200-4560

Fax

(601) 200-4580

NPI assigned

May 21, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Specialty

Neurology

Education

Other, 2017

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• St Dominic Medical Associates LLC

  • Hospitalist Physician
  • Jackson, MS
  • NPI 1285987578
  NPD
• St. Dominic Medical Associates LLC

  • Family Medicine Physician
  • Jackson, MS
  • NPI 1407920549

  Neurology

  NPD
• St Dominic Medical Associates LLC

  • Family Nurse Practitioner
  • Jackson, MS
  • NPI 1508263179
  NPD (past)

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

{
    "created_epoch": "1590019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1891318127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "601-200-4560",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "971 LAKELAND DR STE 557",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164661",
            "telephone_number": "601-200-4560",
            "fax_number": "601-200-4580"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4204 Clay St",
            "address_purpose": "LOCATION",
            "city": "Vicksburg",
            "state": "MS",
            "postal_code": "391833438",
            "country_code": "US",
            "telephone_number": "601-200-4560",
            "fax_number": "601-200-4580",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "810 E Sunflower Rd Ste 100J",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "MS",
            "postal_code": "387322828",
            "country_code": "US",
            "telephone_number": "601-200-4560",
            "fax_number": "601-200-4580",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 The City Dr S",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928683201",
            "country_code": "US",
            "telephone_number": "714-456-8888",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "516 Delaware St SE",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554550356",
            "country_code": "US",
            "telephone_number": "612-624-7374",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OTA",
        "first_name": "RIICHI",
        "middle_name": "ANDRE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-21",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A194002",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "LA",
            "license": "36082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• McKenzie Xiang Denton Ostrander
• Mitchell Ostrander, MD
• Olga Ostrovsky, M.D.
• Lisa J Oswalt- Simmons, CFNP
• Kenneth E. Oswalt, M.D.
• Sharon Othello, RN
• Bryan David Otley, PA-C
• Kristin Otting, PHARM.D.
• Sharon F Otts, LCSW
• Adrian Oudomrath

• Neurology Physician in Jackson, MS
• Providers in Jackson, MS by specialty
• Neurology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2025; 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.