Individual provider Active NPI

Peter Paul Cottone Jr., O.D.

  • Optometrist
  • Watertown, MA
National Provider Identifier
1902945884
Registry record updated Dec 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2306 Issued in MA
Practice address
485 Arsenal St
Arsenal Mall
Watertown, MA 02472-5091
Phone
(617) 926-2070
Fax
(617) 926-2070
NPI assigned
Feb 6, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2306 MA Primary

Addresses

Primary practice location

485 Arsenal St
Arsenal Mall
Watertown, MA 02472-5091

Mailing address

485 Arsenal St
Arsenal Mall
Watertown, MA 02472-5024
Phone (617) 926-2070

Other identifiers 1

IdentifierTypeStateIssuer
0303607MedicaidMA

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
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
2306MAMDClinical Child & Adolescent Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323648000000",
    "number": "1902945884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "485 ARSENAL ST",
            "address_2": "ARSENAL MALL",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024725024",
            "telephone_number": "617-926-2070",
            "fax_number": "617-926-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "485 ARSENAL ST",
            "address_2": "ARSENAL MALL",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024725091",
            "telephone_number": "617-926-2070",
            "fax_number": "617-926-2070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COTTONE",
        "first_name": "PETER",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2011-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "2306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0303607",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.