Individual provider Active NPI

Brooklyn Pierce Otto, PA-C

  • Physician Assistant
  • Muskegon, MI
National Provider Identifier
1093591190
Registry record updated May 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601011961TMP23 Issued in MI
Practice address
1400 Mercy Dr Ste 100
Muskegon, MI 49444-1833
Phone
(231) 733-1326
Fax
(231) 733-5212
NPI assigned
Sep 5, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601011961TMP23 MI Primary

Addresses

Primary practice location

1400 Mercy Dr Ste 100
Muskegon, MI 49444-1833

Mailing address

13411 Pineview Way Apt 204
Southgate, MI 48195-3436

Other practice location 1

13411 Pineview Way Apt 204
Southgate, MI 48195-3436
Phone (858) 437-7790

Other practice location 2

1445 Sheldon Rd Ste 200
Grand Haven, MI 49417-2479
Phone (616) 296-9100

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20231101001083 MI Practitioner - Physician Assistant 8224484985 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Western Michigan Un Homer Stryker School of Med, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Orthopaedic Associates of Muskegon PCGroup PAC ID 7214908045, 113 clinicians

Practice addresses (Care Compare)

1400 Mercy Dr
Suite 100
Muskegon, MI 49444-1833
Phone (231) 733-1326

Hospital & facility affiliations

  • Trinity Health Muskegon Hospital Hospital, Muskegon, MI, CCN 230066
  • Trinity Health Grand Haven Hospital Hospital, Grand Haven, MI, CCN 230174

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601011961TMP23MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Associates of Muskegon, PC CurrentSince Jul 21, 2025 Accepting new patients
US Rehabilitation & Health Service Inc Past Accepting new patients

Locations

1445 Sheldon Rd
Ste 200
Grand Haven, MI 49417
Phone (616) 846-1860

1400 Mercy Dr
Muskegon, MI 49444
Phone (231) 733-1326

1400 Mercy Dr
Ste 100
Muskegon, MI 49444
Phone (231) 733-1326

Interoperability endpoints

  • Direct secure messaging: brooklyn.otto.1@29636.direct.athenahealth.com

Organizations & group practices 2

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 2

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": "1693872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747958400000",
    "number": "1093591190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13411 PINEVIEW WAY APT 204",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481953436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 MERCY DR STE 100",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441833",
            "telephone_number": "231-733-1326",
            "fax_number": "231-733-5212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13411 Pineview Way Apt 204",
            "address_purpose": "LOCATION",
            "city": "Southgate",
            "state": "MI",
            "postal_code": "481953436",
            "country_code": "US",
            "telephone_number": "858-437-7790",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1445 Sheldon Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Grand Haven",
            "state": "MI",
            "postal_code": "494172479",
            "country_code": "US",
            "telephone_number": "616-296-9100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OTTO",
        "first_name": "BROOKLYN",
        "middle_name": "PIERCE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-05",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601011961TMP23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

Verify at the official NPI Registry.