Jenny Ottoson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9115206 Issued in FL

Practice address

12600 Creekside LN Ste 2
Fort Myers, FL 33919-3353

Phone

(239) 343-9235

Fax

(239) 343-4008

NPI assigned

Jul 28, 2016

Last updated

Sep 6, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

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

• Sage Infusion, LLC

  • Infusion Therapy Clinic/Center
  • Tampa, FL
  • NPI 1013578442
  Medicare reassignment NPD

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

{
    "created_epoch": "1469664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1588117352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-9235",
            "fax_number": "239-343-4008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12600 CREEKSIDE LN STE 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339193353",
            "telephone_number": "239-343-9235",
            "fax_number": "239-343-4008"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12651 Whitehall Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339073626",
            "country_code": "US",
            "telephone_number": "239-424-2030",
            "fax_number": "239-343-4117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OTTOSON",
        "first_name": "JENNY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-28",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "12244",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9115206",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MN",
            "license": "12244",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112821000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Margaret Oswiecimski, MD
• Rolando Tomas Otero, M.D.
• William Andrew Ott, SRNA
• An Jalique C Ottley
• Jessica Marie Otton, LCSW
• Rodney Oudi
• Anita Gastel Ouellette, APRN
• Outpatient Anesthesia of Southwest Florida Inc
• Outpatient Anesthesia Specialists LLC
• Nicole Outten, MD

• Physician Assistant in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.