Jaclyn Lisa Otero, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME112268 Issued in FL

Practice address

1600 SW Archer Rd
Gainesville, FL 32610-3003

Phone

(352) 273-6563

Fax

(352) 273-6250

NPI assigned

Apr 1, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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 1

Specialty

Pediatric Medicine

Education

University of Florida College of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Florida Clinical Practice Association IncGroup PAC ID 0345146254, 1,886 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jotero2249@direct.shands.ufl.edu

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.

• Florida Clinical Practice Association Inc

  • Surgery Physician
  • Gainesville, FL
  • NPI 1063463768
  Medicare reassignment Care Compare group NPD
• Florida Clinical Practice Association Inc

  • Durable Medical Equipment & Medical Supplies
  • Ocala, FL
  • NPI 1609529478
  NPD

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

{
    "created_epoch": "1238544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345075200000",
    "number": "1992947238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 918025",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328918025",
            "telephone_number": "352-273-6563",
            "fax_number": "352-273-6250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103003",
            "telephone_number": "352-273-6563",
            "fax_number": "352-273-6250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTERO",
        "first_name": "JACLYN",
        "middle_name": "LISA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-01",
        "last_updated": "2012-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME112268",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005941600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adrienne Ostrov, OTR/L
• Oluwafemi Odunayo Osunnuga, DO
• Oswaldo Javier Rodriguez MD PA
• Mariam Y Otero Nazario
• Agustina Otero
• Nereida Otero
• Sebastian Otero
• Nicholas Alexander Ott, MD
• Rachel Renee Ott, OTR/L
• Marc Edward Ottenga, D.D.S.

• Pediatrics Physician in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2012; 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.