Individual provider Active NPI

Maria Lisa Ott, PSY.D.

  • Clinical Psychologist
  • Centennial, CO
National Provider Identifier
1295936169
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3064 Issued in CO
Practice address
6332 S Jackson St
Centennial, CO 80121-3646
Phone
(843) 441-4128
NPI assigned
May 30, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 3064 CO Primary

Addresses

Primary practice location

6332 S Jackson St
Centennial, CO 80121-3646

Mailing address

6332 S Jackson St
Centennial, CO 80121-3646
Phone (843) 441-4128

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071116000027 CO Practitioner - Clinical Psychologist 3779671227 Reassigns benefits to 1 organization
Practice locations: Colorado Springs, CO

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2490 International Cir
Colorado Springs, CO 80910-3150
Phone (719) 630-8888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3064COMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Maria L. Ott, Psy. D., P.C. Clinical CurrentSince Jan 10, 2015 Accepting new patients
Dr. Horgan & Associates, LLC Clinical Past Accepting new patients

Locations

2490 International Cir
Colorado Springs, CO 80910
Phone (719) 630-8888

2719 N Union Blvd
Colorado Springs, CO 80909
Phone (719) 363-1676

2818 Grand Vista Cir
Colorado Springs, CO 80904
Phone (719) 632-7000

325 S Parkside Dr
Colorado Springs, CO 80910
Phone (719) 471-6512

55 S Parkside Dr
Colorado Springs, CO 80910
Phone (719) 418-4500

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295936169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6332 S JACKSON ST",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801213646",
            "telephone_number": "843-441-4128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6332 S JACKSON ST",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801213646",
            "telephone_number": "843-441-4128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTT",
        "first_name": "MARIA",
        "middle_name": "LISA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "3064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centennial, CO

Sources for this page

Verify at the official NPI Registry.