Individual provider Active NPI

Ann Ottesen, NP

  • Occupational Medicine Physician
  • Bend, OR
National Provider Identifier
1699499582
Registry record updated Jun 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
License
202212407NP-PP Issued in OR
Practice address
3350 NE Manchester CT
Bend, OR 97701-8360
Phone
(541) 640-7243
Fax
(541) 645-7243
NPI assigned
Oct 3, 2022
Last updated
Jun 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2026

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Ostomy Care Registered Nurse 163WX1500X 20140455RN OR
Primary Care Nurse Practitioner 363LP2300X 2022124070NP-PP OR
Nurse Practitioner 363L00000X 202212407NP-PP OR
Wound Care Registered Nurse 163WW0000X 20140455RN OR
Occupational Medicine Physician 2083X0100X 202212407NP-PP OR Primary
Adult Health Nurse Practitioner 363LA2200X 2022124070NP-PP OR
Gerontology Nurse Practitioner 363LG0600X 2022124070NP-PP OR
Registered Nurse 163W00000X 20140455RN OR

Addresses

Primary practice location

3350 NE Manchester CT
Bend, OR 97701-8360

Mailing address

2660 NE Highway 20 Ste 610
Bend, OR 97701-6403
Phone (541) 762-2727

Other identifiers 1

IdentifierTypeStateIssuer
500812411MedicaidOR

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20221214002038 OR Practitioner - Nurse Practitioner 3971972985 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mosaic Community HealthGroup PAC ID 5395653497, 78 clinicians

Practice addresses (Care Compare)

375 NW Beaver St
Suite 101
Prineville, OR 97754-1802
Phone (541) 316-6026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2022124070NP-PPORMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mosaic Community Health CurrentSince Oct 6, 2025 Accepting new patients
Icco, LLC Current Accepting new patients
Icco, LLC CurrentSince Nov 28, 2022 Accepting new patients
Pacific Sage LLC CurrentSince Nov 17, 2024 Accepting new patients
Icco LLC CurrentSince Nov 28, 2022 Accepting new patients

Locations

2660 NE Highway 20
Ste 610
Bend, OR 97701
Phone (541) 228-4775

527 NE Bellevue Dr
Ste 200
Bend, OR 97701
Phone (541) 640-7243

598 E 13th Ave
Eugene, OR 97401
Phone (541) 636-3473

375 NW Beaver St
Ste 101
Prineville, OR 97754
Phone (541) 316-6026

1555 S Highway 97
#101
Redmond, OR 97756
Phone (541) 204-4304

3818 SW 21st St
Ste 100
Redmond, OR 97756
Phone (541) 548-2899

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1664755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781481600000",
    "number": "1699499582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2660 NE HIGHWAY 20 STE 610",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016403",
            "telephone_number": "541-762-2727",
            "fax_number": "541-645-7243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 NE MANCHESTER CT",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977018360",
            "telephone_number": "541-640-7243",
            "fax_number": "541-645-7243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTESEN",
        "first_name": "ANN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-03",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WX1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ostomy Care",
            "state": "OR",
            "license": "20140455RN",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OR",
            "license": "2022124070NP-PP",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "202212407NP-PP",
            "primary": false
        },
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "OR",
            "license": "20140455RN",
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "OR",
            "license": "202212407NP-PP",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OR",
            "license": "2022124070NP-PP",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OR",
            "license": "2022124070NP-PP",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "20140455RN",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500812411",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.