Renae Machelle Otto, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

15482 Issued in MN

Practice address

4040 Coon Rapids Blvd NW Ste 120
Coon Rapids, MN 55433-4568

Phone

(763) 427-9980

NPI assigned

Nov 20, 2025

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 MN

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

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Hospital, Coon Rapids, MN, CCN 240115

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Allina Health System

  • Obstetrics & Gynecology Physician
  • Buffalo, MN
  • NPI 1295272342
  Medicare reassignment Care Compare group
• Allina Health System

  • Cardiovascular Disease Physician
  • Coon Rapids, MN
  • NPI 1366639460
  NPD
• Allina Health System

  • Rheumatology Physician
  • Coon Rapids, MN
  • NPI 1952146516
  NPD

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

• Allina Health System

  • Addiction (Substance Use Disorder) Psychologist
  • Fridley, MN
  • NPI 1083197214

  Hospital

  Care Compare affiliation
• Allina Health System

  • General Acute Care Hospital
  • Cambridge, MN
  • NPI 1215755400
  Care Compare affiliation
• Allina Health System

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Fridley, MN
  • NPI 1285692145
  Care Compare affiliation
• Allina Health System

  • General Acute Care Hospital
  • Coon Rapids, MN
  • NPI 1316904287
  Care Compare affiliation
• Allina Health System

  • Radiation Oncology Clinic/Center
  • Buffalo, MN
  • NPI 1417548959

  Hospital

  Care Compare affiliation
• Allina Health System

  • Maternal & Fetal Medicine Physician
  • Coon Rapids, MN
  • NPI 1447527767

  Hospital

  Care Compare affiliation
• Allina Health System

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fridley, MN
  • NPI 1598700528

  Hospital

  Care Compare affiliation
• Allina Health System

  • Psychiatric Hospital Unit
  • Fridley, MN
  • NPI 1609056100
  Care Compare affiliation

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

{
    "created_epoch": "1763596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765670400000",
    "number": "1295696144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 COON RAPIDS BLVD NW STE 120",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554334568",
            "telephone_number": "763-427-9980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 COON RAPIDS BLVD NW STE 120",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554334568",
            "telephone_number": "763-427-9980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTO",
        "first_name": "RENAE",
        "middle_name": "MACHELLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-20",
        "last_updated": "2025-12-14",
        "certification_date": "2025-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "15482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2025; 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.