Larry Edward Otwell, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1735 Issued in WA

Practice address

72840 Ca-111 S
Suite F201
Palm Desert, CA 92260

Phone

(760) 848-0040

NPI assigned

Sep 16, 2006

Last updated

Feb 27, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Pacific University - College of Optometry, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Iseeu OptometryGroup PAC ID 3577809698, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lotwell2438@ghc.direct-ci.net

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.

• Iseeu Optometry

  • Optometrist
  • Indio, CA
  • NPI 1881177293
  Medicare reassignment Care Compare group NPD
• 310 Vision

  dba Seattle Eyewer

  • Optician
  • Seattle, WA
  • NPI 1407971187
  NPD (past)

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1750487898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "977 BEL AIR DR",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922640663",
            "telephone_number": "206-619-1230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72840 CA-111 S",
            "address_2": "SUITE F201",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "92260",
            "telephone_number": "760-848-0040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 NW Market St",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981075225",
            "country_code": "US",
            "telephone_number": "206-784-0700",
            "fax_number": "206-706-8822",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "310 15th Ave E",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981125103",
            "country_code": "US",
            "telephone_number": "206-326-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "44100 Jefferson St Ste E507",
            "address_purpose": "LOCATION",
            "city": "Indio",
            "state": "CA",
            "postal_code": "922012715",
            "country_code": "US",
            "telephone_number": "760-848-0040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OTWELL",
        "first_name": "LARRY",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "1735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2022259",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "310 15th Ave E",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981125103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jocelyn Orozco
• Talia Orozco, COTA
• Abraham Ortiz, PT
• Doreen Osei
• Luisa Fernanda Ospina, D.D.S.
• Favour Oyewole
• Kimberly Ozmon
• Serkan Ozturk, RPH
• Luis Pacheco, M.D.
• Pacifica Recovery Inc

• Optometrist in Palm Desert, CA
• Providers in Palm Desert, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 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.
• 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.