Emamuzo Obaro Otobo, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

312791 Issued in NY

Practice address

3424 Kossuth Ave Ste 9C-01
Bronx, NY 10467-2410

Phone

(718) 519-4654

Fax

(718) 519-3734

NPI assigned

Feb 28, 2018

Sex

Male

Sole proprietor

No

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, VA, DC3 enrollments

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.

Enrollment records 3

Specialty

Internal Medicine

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

St Peters Hospital of the City of AlbanyGroup PAC ID 2668460072, 268 clinicians

East Post Road Medical Services PCGroup PAC ID 6406198506, 419 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• White Plains Hospital Center Hospital, White Plains, NY, CCN 330304
• St Peter'S Hospital Hospital, Albany, NY, CCN 330057

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989

Interoperability endpoints

• Direct secure messaging: eotobo1800913@direct.trinity-health.org

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.

• East Post Road Medical Services PC

  • Emergency Medicine Physician
  • White Plains, NY
  • NPI 1841767274
  Medicare reassignment Care Compare group NPD
• St. Peter'S Hospital of the City of Albany

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1518042357

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Brookview Medical Associates, PLLC

  • General Practice Physician
  • Bohemia, NY
  • NPI 1871965855
  Medicare reassignment NPD
• Cogent Medical Care PC

  • Internal Medicine Physician
  • East Patchogue, NY
  • NPI 1912941238
  Medicare reassignment NPD
• Great Lakes Physician Practice PC

  • Internal Medicine Physician
  • Jamestown, NY
  • NPI 1730599176
  Medicare reassignment NPD
• Hospitalist Medicine Physicians of New York, PLLC

  • Emergency Medicine Physician
  • Bronx, NY
  • NPI 1205944329
  Medicare reassignment NPD
• Samaritan Hospital of Troy, New York

  • General Acute Care Hospital
  • Troy, NY
  • NPI 1043267727

  Internal Medicine

  Medicare reassignment NPD
• Jamestown Area Medical Associates, L.L.P.

  • Internal Medicine Physician
  • Jamestown, NY
  • NPI 1528010766
  NPD
• St. Peter'S Hospital of the City of Albany

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1497701106

  Internal Medicine

  NPD
• White Plains Hospital Medical Center

  • General Acute Care Hospital
  • White Plains, NY
  • NPI 1447255153
  NPD (past)

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

• St. Peter'S Hospital of the City of Albany

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1497701106
  Care Compare affiliation
• White Plains Hospital Medical Center

  • General Acute Care Hospital
  • White Plains, NY
  • NPI 1447255153
  Care Compare affiliation

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

{
    "created_epoch": "1519776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653436800000",
    "number": "1932601580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3424 KOSSUTH AVE STE 9C-01",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672410",
            "telephone_number": "718-519-4654",
            "fax_number": "718-519-3734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3424 KOSSUTH AVE STE 9C-01",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672410",
            "telephone_number": "718-519-4654",
            "fax_number": "718-519-3734"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 S Manning Blvd",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122081707",
            "country_code": "US",
            "telephone_number": "518-525-1550",
            "fax_number": "518-525-6545",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2215 Burdett Ave",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121802466",
            "country_code": "US",
            "telephone_number": "518-271-3300",
            "fax_number": "518-271-3440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OTOBO",
        "first_name": "EMAMUZO",
        "middle_name": "OBARO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-28",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "312791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2215 Burdett Ave",
            "city": "Troy",
            "state": "NY",
            "country_code": "US",
            "postal_code": "121802466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• James Otero, MSW
• Kevin Edwin Otero, LMHC
• Natacha Marina Otero, CCC-SLP
• Rolly Betita Otero, PTA
• Oleg Otlivanchik, M.D., PH.D.
• Eseoghene Otobo, RN
• Mary Otoo Forson, LPN
• Marra Elizabeth Otoole
• Hatsuko Otsuka, LCSW
• Krystal Anne Ottley, LCSW

• Internal Medicine Physician in Bronx, NY
• Providers in Bronx, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2022; 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.