Individual provider Active NPI

Niki L Ott, PA-C

  • Medical Physician Assistant
  • Truckee, CA
National Provider Identifier
1750519310
Registry record updated Mar 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA20612 Issued in CA
Practice address
10051 Lake Ave Ste 3
Truckee, CA 96161-4870
Phone
(530) 587-7461
Fax
(530) 587-1149
NPI assigned
Jun 22, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA20612 CA Primary

Addresses

Primary practice location

10051 Lake Ave Ste 3
Truckee, CA 96161-4870

Mailing address

10051 Lake Ave Ste 3
Truckee, CA 96161-4870
Phone (530) 587-7461

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091215000250 CA Practitioner - Physician Assistant 4284774738 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Enloe Medical CenterGroup PAC ID 9739092388, 330 clinicians

Practice addresses (Care Compare)

888 Lakeside VLG CMNS
Chico, CA 95928-3979
Phone (530) 332-6850

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA20612CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Enloe Medical Center CurrentSince Mar 3, 2025 Accepting new patients
Family Healthcare Network Current Accepting new patients
Enloe Medical Center CurrentSince Mar 3, 2025 Accepting new patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network CurrentSince May 16, 2016 Accepting new patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network CurrentSince May 16, 2016 Accepting new patients
Enloe Medical Center Past Accepting new patients

Locations

888 Lakeside Vlg Cmns
Chico, CA 95928
Phone (530) 332-6800

33025 Road 159
Ivanhoe, CA 93235
Phone (559) 798-1877

501 N Bridge St
Visalia, CA 93291
Phone (559) 734-1939

305 E Center Ave
Visalia, CA 93291
Phone (559) 737-4792

201 E Lakeview Ave
Woodlake, CA 93286
Phone (559) 564-0100

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CCECCA

Organizations & group practices 12

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.

Hospital & facility affiliations 1

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": "1245628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425340800000",
    "number": "1750519310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10051 LAKE AVE STE 3",
            "city": "TRUCKEE",
            "state": "CA",
            "postal_code": "961614870",
            "telephone_number": "530-587-7461",
            "fax_number": "530-587-1149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10051 LAKE AVE STE 3",
            "city": "TRUCKEE",
            "state": "CA",
            "postal_code": "961614870",
            "telephone_number": "530-587-7461",
            "fax_number": "530-587-1149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTT",
        "first_name": "NIKI",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-22",
        "last_updated": "2015-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA20612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Truckee, CA

Sources for this page

Verify at the official NPI Registry.