Jennifer Lynn Otis

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

3741 Rutledge Rd NE
Albuquerque, NM 87109-5566

Phone

(505) 798-9300

Fax

(505) 798-0808

NPI assigned

Oct 29, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jotis331785@ahs.direct-ci.com
• Direct secure messaging: jennifer.otis.1@8363.direct.athenahealth.com

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.

• Seton Family of Doctors

  • Neurological Surgery Physician
  • Austin, TX
  • NPI 1588997233
  Medicare reassignment NPD
• Pinon Perinatal Inc

  • Maternal & Fetal Medicine Physician
  • Albuquerque, NM
  • NPI 1093829210
  NPD
• Seton Family of Doctors

  • Radiology Clinic/Center
  • Austin, TX
  • NPI 1275290694
  NPD
• Pinon Perinatal

  • Genetic Counselor (M.S.)
  • Albuquerque, NM
  • NPI 1689096190
  NPD (past)

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

{
    "created_epoch": "1603929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1013517978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 LONA LN NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871111619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3741 RUTLEDGE RD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871095566",
            "telephone_number": "505-798-9300",
            "fax_number": "505-798-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTIS",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-29",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madalyn S Otero, SW
• Nicolas John Otero, NICOLAS OTERO
• Simon David Otero III
• Tiffany Lynne Otero, PH.D., BCBA
• Megan Othling, BIRTH DOULA
• Abigail Otoski
• Jessica Otoski, PA-C
• Stacey Otsuka
• Renee Lynn Ott, APN
• Guinevere Ottesen

• Medical Physician Assistant in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Medical Physician Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.