Organization Active NPI

Richard a. Ott, MD, Inc.

  • Specialist
  • Anaheim, CA
National Provider Identifier
1346469020
Registry record updated Aug 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G45864 Issued in CA
Legal business name
RICHARD A. OTT, MD, INC.
Practice address
1211 W la Palma Ave Ste 608
Anaheim, CA 92801-2813
Phone
(714) 774-1102
Fax
(949) 459-0100
NPI assigned
Apr 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2022

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

Authorized official

Name
Richard Alan Ott, MDNPI 1821004144
Title
Physician/Surgeon
Phone
(714) 774-1102

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X G45864 CA Primary

Addresses

Primary practice location

1211 W la Palma Ave Ste 608
Anaheim, CA 92801-2813

Mailing address

PO Box 9036
Newport Beach, CA 92658-1036
Phone (714) 774-1102

Other identifiers 2

IdentifierTypeStateIssuer
GR0095360OtherCACAL-OPTIMA
GR0095360MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040826001028 CA Part B Supplier - Clinic/Group Practice 1951376631 Receives reassigned benefits from 1 practitioner
Practice locations: Anaheim, CA

National Provider Directory

National Provider Directory

Locations

801 N Tustin Ave
Ste 305
Santa Ana, CA 92705
Phone (714) 544-6580

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659744000000",
    "number": "1346469020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9036",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926581036",
            "telephone_number": "714-774-1102",
            "fax_number": "949-459-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 W LA PALMA AVE STE 608",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928012813",
            "telephone_number": "714-774-1102",
            "fax_number": "949-459-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD A. OTT, MD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2022-08-06",
        "certification_date": "2022-08-06",
        "status": "A",
        "authorized_official_last_name": "OTT",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PHYSICIAN/SURGEON",
        "authorized_official_telephone_number": "714-774-1102",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G45864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAL-OPTIMA",
            "identifier": "GR0095360",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0095360",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.