Randolph Otto, MD

Primary specialty

Pediatric Radiology PhysicianTaxonomy code 2085P0229X

License

00027380 Issued in WA

Practice address

2202 S Cedar St Ste 200
Tacoma, WA 98405-2318

Phone

(253) 383-1099

Fax

(253) 383-3919

NPI assigned

Nov 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Diagnostic Radiology

Education

University of Michigan Medical School, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Association of Chrmc and University PhysiciansGroup PAC ID 9133032964, 313 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rotto5285@direct.seattlechildrens.org

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.

• The Association of Chrmc and University Physicians

  • Pediatrics Physician
  • Seattle, WA
  • NPI 1255449963

  Pediatric Radiology

  Medicare reassignment Care Compare group NPD
• Seattle Children'S Hospital

  • Specialist
  • Seattle, WA
  • NPI 1003319500
  Medicare reassignment NPD
• The Association of University Physicians

  • Anesthesiology Physician
  • Seattle, WA
  • NPI 1023041159
  Medicare reassignment NPD
• Association of CHMC and University Physicians

  • Pediatrics Physician
  • Richland, WA
  • NPI 1851680664
  NPD
• Seattle Childrens Hospital

  • Clinic Pharmacy
  • Seattle, WA
  • NPI 1245342153
  NPD
• Pacific Vascular Incorporated

  • Physiological Laboratory
  • Port Ludlow, WA
  • NPI 1336019314
  NPD (past)
• Tacoma Magnetic Imaging LP

  • Radiology Clinic/Center
  • Tacoma, WA
  • NPI 1376612069
  NPD (past)

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881767606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3402 S 18TH ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984051903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 S CEDAR ST STE 200",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984052318",
            "telephone_number": "253-383-1099",
            "fax_number": "253-383-3919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTO",
        "first_name": "RANDOLPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "WA",
            "license": "00027380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8125395",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Ott
• Nathaniel Ott, DNP, ARNP, AGACNP-BC
• Carol Lau Otto, NNP, ARNP
• Le Tu Otto, L.AC
• Matthew David Otto, M.D.
• Yeni Dayanara Oughton
• Qin Ouyang, M.D. PH.D
• Chloe Ovendale
• Rebecca Kathryn Over, D.O.
• Stacie Lynn Overbay, LCSW

• Pediatric Radiology Physician in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Pediatric Radiology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.