Individual provider Active NPI

Sophia Ottaviano, PA-C

  • Physician Assistant
  • Dobbs Ferry, NY
National Provider Identifier
1962366724
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
555 Broadway
Dobbs Ferry, NY 10522-1186
Phone
(914) 674-7600
NPI assigned
Dec 15, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NY Primary

Addresses

Primary practice location

555 Broadway
Dobbs Ferry, NY 10522-1186

Mailing address

555 Broadway
Dobbs Ferry, NY 10522-1186
Phone (914) 674-7600

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260214000054 NY Practitioner - Physician Assistant 0547740086 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Mercy College, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
RB Heart and Vascular Care PLLCGroup PAC ID 9335501634, 19 clinicians

Practice addresses (Care Compare)

4 HDSN Vly Prof PLZ
Newburgh, NY 12550-3157
Phone (781) 530-0070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
RB Heart and Vascular Care PLLC CurrentSince Dec 31, 2025 Accepting new patients

Locations

528 E Main St
Middletown, NY 10940

4 Hdsn Vly Prof Plz
Newburgh, NY 12550
Phone (845) 561-3666

156 Pike St
Port Jervis, NY 12771
Phone (845) 794-7741

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1765756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1962366724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 BROADWAY",
            "city": "DOBBS FERRY",
            "state": "NY",
            "postal_code": "105221186",
            "telephone_number": "914-674-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 BROADWAY",
            "city": "DOBBS FERRY",
            "state": "NY",
            "postal_code": "105221186",
            "telephone_number": "914-674-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTAVIANO",
        "first_name": "SOPHIA",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-15",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dobbs Ferry, NY

Sources for this page

Verify at the official NPI Registry.