Organization Active NPI

Maria L. Ott, Psy. D., P.C.

  • Clinical Psychologist
  • Colorado Springs, CO
National Provider Identifier
1376933168
Registry record updated Feb 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3064 Issued in CO
Legal business name
MARIA L. OTT, PSY. D., P.C.
Practice address
2860 S Circle Dr
100
Colorado Springs, CO 80906-4113
Phone
(719) 465-4340
NPI assigned
Jan 31, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2015

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

Authorized official

Name
Maria Lisa Ott, PSY.D.NPI 1295936169
Title
Clinical Psychologist
Phone
(719) 465-4340

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
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 3064 CO Primary

Addresses

Primary practice location

2860 S Circle Dr
100
Colorado Springs, CO 80906-4113

Mailing address

6455 Bluffmont PT
Colorado Springs, CO 80923-8401
Phone (719) 465-4340

Other identifiers 2

IdentifierTypeStateIssuer
143191MedicaidCO
C811047OtherCOPTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150407001113 CO Part B Supplier - Clinic/Group Practice 9537487335 Receives reassigned benefits from 1 practitioner
Practice locations: Colorado Springs, CO; Co Springs, CO

National Provider Directory

National Provider Directory

Locations

620 Southpointe Ct
Ste 153
Colorado Springs, CO 80906
Phone (719) 465-4340

886 Arcturus Dr
Colorado Springs, CO 80905
Phone (719) 227-7340

Practitioners & affiliated clinicians

Practitioners 1

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": "1422662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424649600000",
    "number": "1376933168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6455 BLUFFMONT PT",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809238401",
            "telephone_number": "719-465-4340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2860 S CIRCLE DR",
            "address_2": "100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809064113",
            "telephone_number": "719-465-4340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIA L. OTT, PSY. D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-31",
        "last_updated": "2015-02-23",
        "status": "A",
        "authorized_official_last_name": "OTT",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "LISA",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "719-465-4340",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "3064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "143191",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "C811047",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2015; 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.