Mrs Alice Camille Otto, NP is a medicare enrolled "Hospitalist" in Lebanon, Indiana. She graduated from nursing school in 2008 and has 16 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Witham Memorial Hospital and her current practice location is
2605 N Lebanon St, Lebanon, Indiana. You can reach out to her office (for appointments etc.) via phone at
(765) 485-8000.
Mrs Alice Camille Otto is licensed to practice in Indiana (license number 71003805A) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1841594025.
Provider's Profile
| Full Name | Mrs Alice Camille Otto |
|---|
| Gender | Female |
|---|
| Speciality | Nurse Practitioner |
|---|
| Experience | 16 Years |
|---|
| Location | 2605 N Lebanon St, Lebanon, Indiana |
|---|
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
|---|
Medical Education and Training:
- Mrs Alice Camille Otto graduated from nursing school in 2008
NPI Data:
- NPI Number: 1841594025
- Provider Enumeration Date: 01/03/2011
- Last Update Date: 10/18/2023
Medicare PECOS Information:
- PECOS PAC ID: 3274709894
- Enrollment ID: I20120104000102
Medical Identifiers
Medical identifiers for Mrs Alice Camille Otto such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1841594025 | NPI | - | NPPES |
| 201042160 | Medicaid | IN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 163W00000X | Registered Nurse | 28196305A (Indiana) | Secondary |
| 363L00000X | Nurse Practitioner | 71003805A (Indiana) | Secondary |
| 363LA2100X | Nurse Practitioner - Acute Care | 71003805A (Indiana) | Secondary |
| 208M00000X | Hospitalist | 71003805A (Indiana) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Witham Memorial Hospital | 4082523170 | 93 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Alice Camille Otto allows following entities to bill medicare on her behalf.
| Entity Name | Witham Memorial Hospital |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1083750293
PECOS PAC ID: 4082523170
Enrollment ID: O20040519001402 |
|---|
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Alice Camille Otto is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mrs Alice Camille Otto, NP
2605 N Lebanon St,
Lebanon, IN 46052-1476
Ph: () - | Mrs Alice Camille Otto, NP
2605 N Lebanon St,
Lebanon, IN 46052-1476
Ph: (765) 485-8000 |
Reviews and Comments