Individual provider Active NPI

Todd W Otto, PA-C

  • Surgical Physician Assistant
  • Lima, OH
National Provider Identifier
1891763678
Registry record updated Apr 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
50001718 Issued in OH
Practice address
801 Medical Dr
Suite a
Lima, OH 45804-4099
Phone
(419) 222-6622
Fax
(419) 224-0015
NPI assigned
Mar 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 50001718 OH Primary

Addresses

Primary practice location

801 Medical Dr
Suite a
Lima, OH 45804-4099

Mailing address

801 Medical Dr
Suite a
Lima, OH 45804-4099
Phone (419) 222-6622

Other identifiers 1

IdentifierTypeStateIssuer
000000491275OtherANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20061009000317 OH Practitioner - Physician Assistant 4688670045 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians Lima Specialty Care LLCGroup PAC ID 7012332364, 254 clinicians

Practice addresses (Care Compare)

730 W Market St
Lima, OH 45801-4602
Phone (419) 226-4310

830 W High St
Ste 207, OH 45801-3969
Phone (419) 226-9182

830 W High St
Suite 390
Lima, OH 45801-3988
Phone (419) 226-9610

Hospital & facility affiliations

  • Mercy Health St Ritas Medical Center Hospital, Lima, OH, CCN 360066

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50001718OHMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Emergency Care Services, Inc. Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: toddotto@glhs.allscriptsdirect.net
  • Direct secure messaging: totto56082@direct.bsmhealth.org

Organizations & group practices 3

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 2

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": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270512000000",
    "number": "1891763678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 MEDICAL DR",
            "address_2": "SUITE A",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458044099",
            "telephone_number": "419-222-6622",
            "fax_number": "419-224-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 MEDICAL DR",
            "address_2": "SUITE A",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458044099",
            "telephone_number": "419-222-6622",
            "fax_number": "419-224-0015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTO",
        "first_name": "TODD",
        "middle_name": "W",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2010-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OH",
            "license": "50001718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000491275",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lima, OH

Sources for this page

Verify at the official NPI Registry.