Kelly Marie Ottis, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C5-0001410 Issued in DE

Practice address

640 S State St
Dover, DE 19901-3530

Phone

(302) 674-4700

NPI assigned

Aug 27, 2013

Sex

Female

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 DE

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

Specialty

Physician Assistant

Education

At Still Un of HLTH Sciences, Col of Osteo Med, Mesa, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bayhealth Medical Center, IncGroup PAC ID 1658364740, 399 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bayhealth Medical Center, Kent Campus Hospital, Dover, DE, CCN 080004

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Bayhealth Medical Center, Inc

  • Colon & Rectal Surgery Physician
  • Dover, DE
  • NPI 1285809509
  Medicare reassignment Care Compare group NPD
• Bayhealth Medical Center, Inc

  • Gastroenterology Physician
  • Milford, DE
  • NPI 1639938525
  NPD

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

• Bayhealth Medical Center, Inc.

  • General Acute Care Hospital
  • Dover, DE
  • NPI 1467546135
  Care Compare affiliation

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

{
    "created_epoch": "1377561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1194159137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 S. STATE ST",
            "address_2": "MAIL CODE 3055",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199013530",
            "telephone_number": "302-480-1688",
            "fax_number": "302-480-9807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 S STATE ST",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199013530",
            "telephone_number": "302-674-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTIS",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-27",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C5-0001410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Osei-Afriyie, FNP
• Francis T. Ostrea, MD
• Abimbola Osunyele Osunkoya, M.D, M.R., C.O.G.
• Mohamed Othman
• Lauri Ott
• Outpatient Urology Center of Dover, LLC
• Elizabeth Ann Outten, PA-C
• Caitlin Owens
• Afua Owusu-Donkor, PA-C
• Nana-Amma Mintaa Owusu-Donkor, LCSW

• Physician Assistant in Dover, DE
• Providers in Dover, DE by specialty
• Physician Assistant in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; 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.