Mary Otteman, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2023 Issued in NE

Practice address

16910 Frances St
Omaha, NE 68130-2398

Phone

(402) 505-8777

Fax

(402) 933-7767

NPI assigned

Jul 26, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mary Obrist Former name

Medicare fee-for-service enrollment

Enrolled in NE

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mod Dermatology PCGroup PAC ID 9638430804, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The Nebraska Medical Center Hospital, Omaha, NE, CCN 280013

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Mod Dermatology PC

  • Dermatology Physician
  • Omaha, NE
  • NPI 1982105425
  Medicare reassignment Care Compare group
• Unmc Physicians

  • Multi-Specialty Clinic/Center
  • Omaha, NE
  • NPI 1417912114
  Medicare reassignment

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

• The Nebraska Medical Center

  • General Acute Care Hospital
  • Omaha, NE
  • NPI 1356307581
  Care Compare affiliation

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

{
    "created_epoch": "1469491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657065600000",
    "number": "1821541905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16910 FRANCES ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681302398",
            "telephone_number": "402-505-8777",
            "fax_number": "402-933-7767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16910 FRANCES ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681302398",
            "telephone_number": "402-505-8777",
            "fax_number": "402-933-7767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTEMAN",
        "first_name": "MARY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-26",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "2023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "OBRIST",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Paige Ott
• Sarah L Ott, DMD
• Brandi M Otte, RN
• Jessica M Otte
• Mindy Ann Otte, MS, CCC-SLP
• John J Otten, M.D., D.D.S.
• Julie Anne Otten
• Julie S Otten, PT
• Erik Thor Otterberg, MD
• Angela Otterstein, MS, PLMHP

• Physician Assistant in Omaha, NE
• Providers in Omaha, NE by specialty
• Physician Assistant in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2022; 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.