Individual provider Active NPI

Richard Otto, M.D.

  • Urology Physician
  • Milwaukee, WI
National Provider Identifier
1487913513
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
75503 Issued in WI
Practice address
3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Phone
(414) 352-3100
NPI assigned
May 9, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 079294 GA
Urology Physician 208800000X 75503 WI Primary

Addresses

Primary practice location

3003 W Good Hope Rd
Milwaukee, WI 53209-2042

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

1836 South Ave
LA Crosse, WI 54601-5429
Phone (608) 782-7300

Other identifiers 1

IdentifierTypeStateIssuer
100176271MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address rotto325450@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, WI, VA3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20180705001264 GA Practitioner - Urology 4981998788 Reassigns benefits to 1 organization
I20210811002250 WI Practitioner - Urology 4981998788 Reassigns benefits to 1 organization
I20241021002297 VA Practitioner - Urology 4981998788 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Wake Forest University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Winchester Medical CenterGroup PAC ID 0244134021, 313 clinicians

Practice addresses (Care Compare)

1712 Amherst St
Winchester, VA 22601-2807
Phone (540) 667-1712

Hospital & facility affiliations

  • Winchester Medical Center Hospital, Winchester, VA, CCN 490005
  • Shenandoah Memorial Hospital Hospital, Woodstock, VA, CCN 491305
  • Warren Memorial Hospital Hospital, Front Royal, VA, CCN 490033
  • Page Memorial Hospital, Inc Hospital, Luray, VA, CCN 491307
  • Hampshire Memorial Hospital Hospital, Romney, WV, CCN 511311

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Gundersen Lutheran Medical Center Inc Current Accepting new patients
St. Francis Physician Practices LLC Current Accepting new patients
St. Francis Physician Practices LLC CurrentSince Nov 6, 2018 Accepting new patients
Tift Regional Health System Inc CurrentSince Jan 12, 2018 Accepting new patients
St Francis Physician Practices LLC CurrentSince Nov 6, 2018 Accepting new patients
Winchester Medical Center CurrentSince Oct 1, 2024 Accepting new patients
Gundersen Lutheran Medical Center, Inc CurrentSince Jul 30, 2021 Accepting new patients
Gundersen Lutheran Medical Center, Inc CurrentSince Jul 30, 2021 Accepting new patients
Winchester Medical Center Current Accepting new patients
Winchester Medical Center CurrentSince Oct 1, 2024 Accepting new patients
Winchester Medical Center Past Accepting new patients

Locations

2122 Manchstr Expy
Columbus, GA 31904
Phone (706) 320-3128

2300 Manchester Expy
Ste A002
Columbus, GA 31904
Phone (706) 320-3203

901 18th St E
Tifton, GA 31794
Phone (229) 353-6208

2225 US Highway 41 N
Tifton, GA 31794
Phone (229) 353-3422

2227 US Highway 41 N
Tifton, GA 31794
Phone (229) 353-6188

220 Campus Blvd
Ste 320
Winchester, VA 22601

1840 Amherst St
Winchester, VA 22601
Phone (540) 536-8700

1712 Amherst St
Winchester, VA 22601
Phone (540) 667-1712

1836 South Ave
La Crosse, WI 54601
Phone (608) 788-8102

1910 South Ave
La Crosse, WI 54601
Phone (608) 775-2287

Interoperability endpoints

  • Direct secure messaging: rotto1458976@valleyhealth.direct-ci.com
  • Direct secure messaging: rotto325450@direct.myadvocateaurora.org

Organizations & group practices 11

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1336521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1487913513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3003 W GOOD HOPE RD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532092042",
            "telephone_number": "414-352-3100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1836 South Ave",
            "address_purpose": "LOCATION",
            "city": "LA Crosse",
            "state": "WI",
            "postal_code": "546015429",
            "country_code": "US",
            "telephone_number": "608-782-7300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OTTO",
        "first_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-09",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "GA",
            "license": "079294",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "WI",
            "license": "75503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100176271",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rotto325450@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "W3985 County Road Nn",
            "city": "Elkhorn",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531214337",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "W3985 County Road Nn",
            "city": "Elkhorn",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531214337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.