Kyle Edward Otto, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

300687 Issued in CA

Practice address

32650 State Route 20 # E110
Oak Harbor, WA 98277-2641

Phone

(360) 279-0100

Fax

(360) 279-0111

NPI assigned

Feb 14, 2024

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

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Skagit Island Rehabilitation Group LLCGroup PAC ID 9739469651, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Skagit Island Rehabilitation Group LLC

  • Physical Therapist
  • Oak Harbor, WA
  • NPI 1497102792
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1707868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1962267468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 R AVE UNIT 110",
            "city": "ANACORTES",
            "state": "WA",
            "postal_code": "982214602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32650 STATE ROUTE 20 # E110",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982772641",
            "telephone_number": "360-279-0100",
            "fax_number": "360-279-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTO",
        "first_name": "KYLE",
        "middle_name": "EDWARD",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-14",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "300687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carmen Ortiz
• Jasmine Ortiz
• Katelyn Osborn
• Michael Wray Ostrom, DDS
• Jaime Anne Otto
• Kelsey Owen, M.S., BCBA
• Sarah C Owen, ARNP
• Maria Packard
• Cadesha Pacquette
• Mare Pallerine, DNP, ARNP, PMHNP-BC

• Physical Therapist in Oak Harbor, WA
• Providers in Oak Harbor, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.