Active NPI
Andrea L Ott, PA-C
- Physician Assistant
- Blair, NE
National Provider Identifier
1619114246
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1416
- Practice address
- 812 N 22ND Street
Blair Clinic
Blair, NE 68008 - Phone
- (402) 426-4611
- NPI assigned
- Jan 20, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 1416 | NE | |
| Physician Assistant | 363A00000X | 1416 | NE | Primary |
Addresses
Primary practice location
812 N 22ND Street
Blair Clinic
Blair, NE 68008
Mailing address
810 N 22ND Street
MCH & Health System
Blair, NE 68008
Phone (402) 426-2182
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children'S Specialty Physician Billing | Past | Accepting new patients | |
| Nebraska Pediatric Practice, Inc | Past | Accepting new patients |
Interoperability endpoints
- aott20994@direct.nebraskamed.com
Organizations & group practices 3
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.
-
- Multi-Specialty Clinic/Center
- Omaha, NE
- NPI 1417912114
-
- Pediatric Nurse Practitioner
- Omaha, NE
- NPI 1013040369
-
- Pediatrics Physician
- Omaha, NE
- NPI 1144556333
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1232409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277424000000",
"number": "1619114246",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "810 N 22ND STREET",
"address_2": "MCH & HEALTH SYSTEM",
"city": "BLAIR",
"state": "NE",
"postal_code": "68008",
"telephone_number": "402-426-2182",
"fax_number": "402-426-1297"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "812 N 22ND STREET",
"address_2": "BLAIR CLINIC",
"city": "BLAIR",
"state": "NE",
"postal_code": "68008",
"telephone_number": "402-426-4611"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OTT",
"first_name": "ANDREA",
"middle_name": "L",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-01-20",
"last_updated": "2010-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NE",
"license": "1416",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NE",
"license": "1416",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blair, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2010; 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.