Individual provider Active NPI

Daniel Joseph Otterson, MD

  • Internal Medicine Physician
  • Irvine, CA
National Provider Identifier
1093210973
Registry record updated Mar 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
178820 Issued in CA
Practice address
1 Medical Plaza Drive
Irvine, CA 92697-4875
Phone
(949) 824-8600
NPI assigned
Mar 24, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 178820 CA
Internal Medicine Physician 207R00000X 178820 CA Primary

Addresses

Primary practice location

1 Medical Plaza Drive
Irvine, CA 92697-4875

Mailing address

200 S Manchester Ave Ste 300
Orange, CA 92868-3219
Phone (714) 456-2986

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20220811002537 CA Practitioner - Internal Medicine 8325477698 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Georgetown University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
UC RegentsGroup PAC ID 7416869516, 316 clinicians

Practice addresses (Care Compare)

101 The City Dr S
Orange, CA 92868-3201
Phone (714) 456-7004

Hospital & facility affiliations

  • Mission Home Health of Irvine, LLC Home health agency, Irvine, CA, CCN 053149
  • Uci Health-Orange Hospital, Orange, CA, CCN 050348

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
178820CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UC Regents Internal Medicine CurrentSince Sep 1, 2022 Accepting new patients
UC Regents CurrentSince Sep 1, 2022 Accepting new patients
UC Regents Current Accepting new patients
University of California Irvine Past Accepting new patients
University of California Irvine Past Accepting new patients

Locations

19200 Jamboree Rd
Ste 3100
Irvine, CA 92612

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

Organizations & group practices 5

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1521849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1093210973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S MANCHESTER AVE STE 300",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683219",
            "telephone_number": "714-456-2986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PLAZA DRIVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926974875",
            "telephone_number": "949-824-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTERSON",
        "first_name": "DANIEL",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-24",
        "last_updated": "2023-03-21",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "178820",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "178820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.