Chris Otto, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA734 Issued in WY

Practice address

3236 E Grand Ave Ste D
Laramie, WY 82070-5100

Phone

(307) 760-8602

Fax

(307) 460-9880

NPI assigned

May 19, 2016

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 WY, CO2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Care United Medical Center of Laramie LLCGroup PAC ID 7719168491, 18 clinicians

Ivinson Memorial HospitalGroup PAC ID 8325304447, 61 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ivinson Memorial Hospital Hospital, Laramie, WY, CCN 530025

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Care United Medical Center of Laramie, LLC

  dba BestMed

  • Multi-Specialty Clinic/Center
  • Laramie, WY
  • NPI 1063720605

  CO

  Medicare reassignment Care Compare group
• Ivinson Memorial Hospital

  • Rural Health Clinic/Center
  • Laramie, WY
  • NPI 1033628599
  Medicare reassignment Care Compare group
• College Drive Urgent Care LLC

  • Urgent Care Clinic/Center
  • Cheyenne, WY
  • NPI 1467601765
  Medicare reassignment

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

• Ivinson Memorial Hospital

  • Rural Acute Care Hospital
  • Laramie, WY
  • NPI 1336289552
  Care Compare affiliation

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

{
    "created_epoch": "1463616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1982051850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3236 E GRAND AVE STE D",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820705100",
            "telephone_number": "307-760-8602",
            "fax_number": "307-460-9880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3236 E GRAND AVE STE D",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820705100",
            "telephone_number": "307-760-8602",
            "fax_number": "307-460-9880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3810 E Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Laramie",
            "state": "WY",
            "postal_code": "820705179",
            "country_code": "US",
            "telephone_number": "307-721-1794",
            "fax_number": "307-721-1795",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OTTO",
        "first_name": "CHRIS",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-19",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WY",
            "license": "PA734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Zora Owens
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• Medical Physician Assistant in Laramie, WY
• Providers in Laramie, WY by specialty
• Medical Physician Assistant in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; 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.