Gary M Ottersbach, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

115 Issued in WY

Practice address

2521 E 15TH St
Casper, WY 82609-4126

Phone

(307) 472-2293

NPI assigned

Oct 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WY

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

Specialty

Physician Assistant

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Banner Health Physicians West LLCGroup PAC ID 5092978866, 92 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner Wyoming Medical Center Hospital, Casper, WY, CCN 530012
• Memorial Hospital of Converse County Hospital, Douglas, WY, CCN 531302

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Banner Health Physicians West LLC

  • Multi-Specialty Clinic/Center
  • Casper, WY
  • NPI 1063778728

  WY

  Medicare reassignment Care Compare group
• Banner Health Physicians West LLC

  • Multi-Specialty Clinic/Center
  • Ogallala, NE
  • NPI 1154687812
  Care Compare group NPD
• Lusk Medical Clinic

  • Rural Health Clinic/Center
  • Lusk, WY
  • NPI 1750311072
  NPD (past) Authorized official
• Banner Health Physicians West LLC

  • Multi-Specialty Clinic/Center
  • Fallon, NV
  • NPI 1427314186
  Care Compare group

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

• Memorial Hospital of Converse County

  • Critical Access Hospital
  • Douglas, WY
  • NPI 1326085408

  Hospital

  Care Compare affiliation
• Wyoming Medical Center Inc

  • General Acute Care Hospital
  • Casper, WY
  • NPI 1346332954

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269993600000",
    "number": "1699861732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2521 E 15TH ST",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826094126",
            "telephone_number": "307-472-2293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2521 E 15TH ST",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826094126",
            "telephone_number": "307-472-2293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTERSBACH",
        "first_name": "GARY",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2010-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA1001",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WY",
            "license": "115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Maliha D Owens, LPC
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• All providers in Casper, WY
• Medical Physician Assistant in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.