NPIMap

Individual provider Active NPI

Charlton Graham Otte

  • Neurology Physician
  • Philadelphia, PA
National Provider Identifier
1629655881
Registry record updated Jan 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
MD488691 Issued in PA
Practice address
3401 N Broad St
Philadelphia, PA 19140-5103
Phone
(215) 707-3040
NPI assigned
Mar 25, 2021
Last updated
Jan 26, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X MD488691 PA Primary
Neurology Physician 2084N0400X 1629655881 IL

Addresses

Primary practice location

3401 N Broad St
Philadelphia, PA 19140-5103

Mailing address

3509 N Broad St
Philadelphia, PA 19140-4105

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250401000918 PA Practitioner - Neurology 4486002250 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Pittsburgh School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Temple Faculty Practice Plan IncGroup PAC ID 0345588711, 1,325 clinicians

Practice addresses (Care Compare)

3401 N Broad St
Philadelphia, PA 19140-5103
Phone (215) 707-3008

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1629655881ILMDNeurology Physician
MD488691PAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Faculty Practice Plan Inc CurrentSince May 11, 2025 Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince May 11, 2025 Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients

Locations

515 Pennsylvania Ave
Ft Washington, PA 19034
Phone (215) 641-0700

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

3500 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3656

3509 N Broad St
Philadelphia, PA 19140
Phone (215) 707-2433

Interoperability endpoints

  • Direct secure messaging: charlton.otte.1@3547.direct.athenahealth.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1616630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769385600000",
    "number": "1629655881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3509 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191404105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "215-707-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTE",
        "first_name": "CHARLTON",
        "middle_name": "GRAHAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-25",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "PA",
            "license": "MD488691",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "1629655881",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.