Individual provider Active NPI

Motaz Othman, ACNPC-AG

  • Acute Care Nurse Practitioner
  • Riverside, CA
National Provider Identifier
1992651970
Registry record updated Mar 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
95038837 Issued in CA
Practice address
14319 Martin PL
Riverside, CA 92503-7461
Phone
(951) 880-5628
NPI assigned
Mar 10, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 95038837 CA Primary

Addresses

Primary practice location

14319 Martin PL
Riverside, CA 92503-7461

Mailing address

14319 Martin PL
Riverside, CA 92503-7461

Medicare participation

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

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

14319 Martin PL
Riverside, CA 92503-7461

17595 Harvard Ave
Irvine, CA 92614-8516

8623 Moody St
Cypress, CA 90630-2239

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95038837CAMDAcute Care Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1773100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773100800000",
    "number": "1992651970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14319 MARTIN PL",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925037461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14319 MARTIN PL",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925037461",
            "telephone_number": "951-880-5628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTHMAN",
        "first_name": "MOTAZ",
        "credential": "ACNPC-AG",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-03-10",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95038837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.