LISSETTE ALEXANDRA OTERO NP
NPI 1255037065
Nurse Practitioner - Adult Health in New York, NY
About Lissette Alexandra Otero Np NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LISSETTE ALEXANDRA OTERO NP (NPI 1255037065) is an individual adult health provider in New York, New York, licensed in New York (311049) and active in the NPI registry since February 2023. She is enrolled in Medicare PECOS, maintains a secondary practice location in New York, and is a graduate of Other (2022).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Lissette Alexandra Otero Np is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Lissette Otero reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Brooklyn, NY 11212
- Reassigned Medicare billing, New York enrollment
- 73 clinicians in this Medicare group
Brooklyn, NY 11212
- Reassigned Medicare billing, New York enrollment
- Medicare enrollment name: Griffin Myers Medical PC
- 101 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 2
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 10040 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
NEW YORK, NY 10040
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Lissette Otero's NPI number?
The NPI number for Lissette Otero is 1255037065. It was assigned to this individual provider in the NPPES registry on February 2, 2023.
Where is Lissette Otero located?
Lissette Otero practices at 4405 Broadway, New York, NY 10040. The listed phone number is (212) 740-2020.
What is Lissette Otero's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.
Is Lissette Otero enrolled in Medicare?
Yes. Lissette Otero is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Lissette Otero's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Lissette Otero reassigns Medicare benefits to 2 organizations: Doral Medical And Multi Specialty Facility LLC (Brooklyn, NY) and Oak Street Health Of New York Medical Group PC (Brooklyn, NY). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Lissette Otero's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Lissette Otero was last updated on April 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Lissette Alexandra Otero, NP · NPI 1255037065
Adult Health physician in New York, New York. Individual provider, active in the CMS NPPES registry since February 2, 2023.
## Identity
- **NPI:** 1255037065 (Entity type: Individual)
- **Enumerated:** February 2, 2023
- **Primary specialty:** Nurse Practitioner - Adult Health · taxonomy 363LA2200X
- **State license:** 311049 (New York)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 4405 BROADWAY, New York, NY 10040-4014
- **Phone:** (212) 740-2020 · **Fax:** (646) 666-0280
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Doral Medical And Multi Specialty Facility LLC (NPI 1144693607, Brooklyn, NY); Oak Street Health Of New York Medical Group PC (NPI 1780209445, Brooklyn, NY) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2022
## Record status
- **NPPES last updated:** April 13, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1255037065) · Data from the CMS NPPES public registry.