Peter Ottavio, DO in Port Jefferson Station, NY

Peter Ottavio, DO is a medicare enrolled "Internal Medicine - Pulmonary Disease" physician in Port Jefferson Station, New York. His current practice location is 1500 Route 112 Ste B, Port Jefferson Station, New York. You can reach out to his office (for appointments etc.) via phone at (631) 978-7633.

Peter Ottavio is licensed to practice in New York (license number 232660) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1093750028.

Contact Information

	Peter Ottavio, DO
	1500 Route 112 Ste B, Port Jefferson Station, NY 11776-8055
	(631) 978-7633
	(631) 621-4115

Map and Direction

Physician's Profile

Full Name	Peter Ottavio
Gender	Male
Speciality	Internal Medicine - Pulmonary Disease
Location	1500 Route 112 Ste B, Port Jefferson Station, New York
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1093750028
Provider Enumeration Date: 06/16/2006
Last Update Date: 10/22/2020

Medicare PECOS Information:

PECOS PAC ID: 2961506076
Enrollment ID: I20070329000565

Medical Identifiers

Medical identifiers for Peter Ottavio such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1093750028	NPI	-	NPPES
232660	Other	NY	LICENSE NUMBER

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207R00000X	Internal Medicine	232660 (New York)	Secondary
207RC0200X	Internal Medicine - Critical Care Medicine	232660 (New York)	Secondary
207RS0012X	Internal Medicine - Sleep Medicine	232660 (New York)	Secondary
207RP1001X	Internal Medicine - Pulmonary Disease	232660 (New York)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Peter Ottavio allows following entities to bill medicare on his behalf.

Entity Name	Optum Medical Care Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1982643003 PECOS PAC ID: 9931013240 Enrollment ID: O20031119000321

Entity Name	Prohealth Care Associates Llp
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1275596280 PECOS PAC ID: 4486544186 Enrollment ID: O20040317000468

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Peter Ottavio is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Peter Ottavio, DO 500 Commack Rd, Commack, NY 11725-5020 Ph: (631) 675-2125	Peter Ottavio, DO 1500 Route 112 Ste B, Port Jefferson Station, NY 11776-8055 Ph: (631) 978-7633

Reviews and Comments

Internal Medicine Doctors in Port Jefferson Station, NY

Dr. Michael W Mendelson, M.D. Pulmonary Disease Medicare: Accepting Medicare Assignments Practice Location: 5360 Nesconset Hghy, Suite B, Port Jefferson Station, NY 11776 Phone: 631-331-3200 Fax: 631-331-3694
Matias M Dcosta, MD Pulmonary Disease Medicare: Accepting Medicare Assignments Practice Location: 931 Hallock Ave, Port Jefferson Station, NY 11776 Phone: 631-331-7200 Fax: 631-331-8636
Dr. Iryna Ilyasova, M.D Pulmonary Disease Medicare: Accepting Medicare Assignments Practice Location: 1500 Route 112 Ste A, Port Jefferson Station, NY 11776 Phone: 631-686-1414
Kinjal Amit Gosalia, STUDENT Pulmonary Disease Medicare: Medicare Enrolled Practice Location: 5316 Nesconset Hwy, Port Jefferson Station, NY 11776 Phone: 631-758-7003 Fax: 631-751-0506
Zarlasht Khan, Pulmonary Disease Medicare: Accepting Medicare Assignments Practice Location: 1500 Route 112, Port Jefferson Station, NY 11776 Phone: 631-743-6840
Anil Sangwan, M.D. Pulmonary Disease Medicare: Accepting Medicare Assignments Practice Location: 116 Terryville Rd, Port Jefferson Station, NY 11776 Phone: 631-928-2002 Fax: 631-473-4427
Anish Desai, MD Pulmonary Disease Medicare: Accepting Medicare Assignments Practice Location: 1500 Route 112 Ste B, Port Jefferson Station, NY 11776 Phone: 631-978-7633 Fax: 631-621-4119

Peter Ottavio, DO - Medicare Internal Medicine in Port Jefferson Station, NY