Travis Lewellen Otto, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY8595 Issued in FL

Practice address

2505 Crowder LN
Tampa, FL 33629-6253

Phone

(813) 361-4809

NPI assigned

Sep 18, 2012

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

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1347926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410825600000",
    "number": "1093065955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6225 WILLET CT",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342028224",
            "telephone_number": "813-361-4809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 CROWDER LN",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336296253",
            "telephone_number": "813-361-4809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTO",
        "first_name": "TRAVIS",
        "middle_name": "LEWELLEN",
        "name_prefix": "Mr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-18",
        "last_updated": "2014-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY8595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Otteni, M.D.
• Allie Morgan Ottinger, MD
• Mary Ottinger, M.D.
• Kristen Johnson Otto, M.D.
• Richard Drew Otto, M.D.
• Daniella Otun
• Yangchong Ou
• Michelle Catherine Ouellette, MD
• Rortana Oum, AAC
• Our Lady of Charity Alf LLC

• Clinical Psychologist in Tampa, FL
• Providers in Tampa, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2014; 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.