ETINOSA OTAGHO
NPI 1538717103
Physician Assistant - Surgical in New Hyde Park, NY
About Etinosa Otagho NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ETINOSA OTAGHO (NPI 1538717103) is an individual surgical provider in New Hyde Park, New York and active in the NPI registry since August 2019. He is enrolled in Medicare PECOS, is affiliated with Long Island Jewish Medical Center, and is a graduate of Mercy College (2019).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Etinosa Otagho 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.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Long Island Jewish Medical Center
Acute Care Hospitals · New Hyde Park, NYMedicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
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 HYDE PARK, NY 11040
NEW HYDE PARK, NY 11040
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 Etinosa Otagho's NPI number?
The NPI number for Etinosa Otagho is 1538717103. It was assigned to this individual provider in the NPPES registry on August 27, 2019.
Where is Etinosa Otagho located?
Etinosa Otagho practices at 27005 76th Ave, New Hyde Park, NY 11040. The listed phone number is (718) 470-7000.
What is Etinosa Otagho's specialty?
The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.
Is Etinosa Otagho enrolled in Medicare?
Yes. Etinosa Otagho 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.
Is Etinosa Otagho affiliated with any hospitals?
According to CMS data, Etinosa Otagho is affiliated with Long Island Jewish Medical Center.
When was this NPI record last updated?
The NPPES record for Etinosa Otagho was last updated on August 27, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.
# Etinosa Otagho · NPI 1538717103
Surgical physician in New Hyde Park, New York. Individual provider, active in the CMS NPPES registry since August 27, 2019.
## Identity
- **NPI:** 1538717103 (Entity type: Individual)
- **Enumerated:** August 27, 2019
- **Primary specialty:** Physician Assistant - Surgical · taxonomy 363AS0400X
- **Sole proprietor:** No
## Practice location
- **Address:** 27005 76TH AVE, New Hyde Park, NY 11040-1496
- **Phone:** (718) 470-7000
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Mercy College, class of 2019
## Record status
- **NPPES last updated:** August 27, 2019
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Source: [NPI Profile](https://npiprofile.com/npi/1538717103) · Data from the CMS NPPES public registry.