Ichiro Otsu, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

MD00038794 Issued in WA

Practice address

400 S 43Rd St
Renton, WA 98055-5714

Phone

(425) 353-3788

Fax

(425) 353-8041

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WA

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

Anesthesiology

Education

Other, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Valley Anesthesia Associates PLLCGroup PAC ID 0941112098, 45 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Valley Medical Center Hospital, Renton, WA, CCN 500088

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Valley Anesthesia Associates, PLLC

  • Anesthesiology Physician
  • Renton, WA
  • NPI 1033165097
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Public Hospital District 1 of King County

  • General Acute Care Hospital
  • Renton, WA
  • NPI 1649209230
  Care Compare affiliation
• Valley Medical Group-Renton

  • General Acute Care Hospital
  • Renton, WA
  • NPI 1619209574
  Care Compare affiliation

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1053422378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 84571",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981245871",
            "telephone_number": "425-353-3788",
            "fax_number": "425-353-8041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S 43RD ST",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555714",
            "telephone_number": "425-353-3788",
            "fax_number": "425-353-8041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTSU",
        "first_name": "ICHIRO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "MD00038794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "0157556",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8286080",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diana C Orr, OT
• Alondra Ortiz
• Alexis Osborne
• Osmed Spine Clinic PS
• Josephine A Otieno
• Kristen M Oulton, AUDIOLOGIST
• Linda L Overland-Smith, RN
• Stephanie Marie Owens, OT
• Pacific Chiropractic, LLC
• Pacific Medical, Inc.

• Anesthesiology Physician in Renton, WA
• Providers in Renton, WA by specialty
• Anesthesiology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.