Active NPI
Bradley A. Otto, MD
- Otolaryngology Physician
- Columbus, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 35084019
- Practice address
- 915 Olentangy River Rd Ste 4000
Columbus, OH 43212-3154 - Phone
- (614) 366-3687
- Fax
- (614) 293-6176
- NPI assigned
- Jun 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 35084019 | OH | |
| Otolaryngology Physician | 207Y00000X | 35084019 | OH | Primary |
Addresses
Primary practice location
915 Olentangy River Rd Ste 4000
Columbus, OH 43212-3154
Mailing address
700 Ackerman Rd Ste 2120
Columbus, OH 43202-1559
Phone (614) 293-2594
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2539971 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Otolaryngology
- Education
- Wright State University Boonshoft School of Medicine, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
410 W 10TH Ave
Columbus, OH 43210-1240
Phone (614) 366-3687
450 W 10TH Ave
Columbus, OH 43210-1240
Phone (614) 366-3687
452 W 10TH Ave
Columbus, OH 43210-1240
Phone (614) 366-3687
460 W 10TH Ave
Columbus, OH 43210-1240
Phone (614) 366-3687
6700 University Blvd
Dublin, OH 43016-3508
Phone (614) 366-3687
915 Olentangy River Rd
Columbus, OH 43212-3153
Phone (614) 366-3687
Hospital & facility affiliations
- Ohio State University State Health System
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Osu Otolaryngology Head and Neck Surgery LLC | Otolaryngology | Current | Accepting new patients |
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
Locations
915 Olentangy River Rd
Columbus, OH 43212
915 Olentangy River Rd
Ste 4000
Columbus, OH 43212
Phone (614) 293-9215
700 Ackerman Rd
Ste 570
Columbus, OH 43202
Phone (614) 293-2046
700 Ackerman Rd
Ste 2120
Columbus, OH 43202
410 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905
Interoperability endpoints
- botto7677@direct.osumc.edu
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.
-
- Otolaryngology Physician
- Columbus, OH
- NPI 1861449407
-
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Rehabilitation Hospital Unit
- Columbus, OH
- NPI 1184723637
-
- General Acute Care Hospital
- Columbus, OH
- NPI 1447359997
-
- Psychiatric Hospital Unit
- Columbus, OH
- NPI 1790876183
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612828800000",
"number": "1114969185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 ACKERMAN RD STE 2120",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432021559",
"telephone_number": "614-293-2594",
"fax_number": "614-293-4487"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "915 OLENTANGY RIVER RD STE 4000",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432123154",
"telephone_number": "614-366-3687",
"fax_number": "614-293-6176"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OTTO",
"first_name": "BRADLEY",
"middle_name": "A.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-12",
"last_updated": "2021-02-09",
"certification_date": "2021-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "OH",
"license": "35084019",
"primary": false
},
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "OH",
"license": "35084019",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2539971",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2021; 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.