MARK CONRAD OTTELIN MD
NPI 1164418216
Urology in Greensboro, NC

Q: What is Mark Ottelin's NPI number?

The NPI number for Mark Ottelin is 1164418216. It was assigned to this individual provider in the NPPES registry on September 23, 2005.

Q: What is Mark Ottelin's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Q: When was this NPI record last updated?

The NPPES record for Mark Ottelin was last updated on February 11, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 23, 2005PECOS Enrolled

509 N ELAM AVE FL 2, GREENSBORO, NC 27403(336) 274-1114(336) 232-5325 Get Directions Write a Review

NPPES record last updated: February 11, 2011. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Mark Conrad Ottelin Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARK CONRAD OTTELIN MD (NPI 1164418216) is an individual urology provider in Greensboro, North Carolina, licensed in North Carolina (35458) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1164418216

Entity TypeIndividualMale

Primary Taxonomy208800000X

Provider Legal NameMARK CONRAD OTTELINCredential: MD

Location Address509 N ELAM AVE FL 2Greensboro, NC 27403-1157

Mailing Address509 N Elam Ave Fl 2Greensboro, NC 27403-1157 · (336) 274-1114 · Fax (336) 232-5325

Phone(336) 274-1114

Fax(336) 232-5325

Sole ProprietorNo

Enumeration DateSeptember 23, 2005

Last NPPES UpdateFebruary 11, 2011

✔ NPI 1164418216 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians

Taxonomy Code208800000X

License✔ Licensed in NC · 35458

Definition

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

509 N ELAM AVE FL 2, Greensboro, NC 27403

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Other Identifiers 7

Medicare UPINC63946NC

Medicaid8964398NC

Medicare PIN2171346DNC

Other64398NC · Blue Cross Blue Shield

Medicare PIN2171346ENC

Medicare PIN2171346BNC

Medicare PIN340017966

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mark Conrad Ottelin Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Mark Ottelin reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Urology Specialists Of The Carolinas PLLC

Same address

Urology

509 N ELAM AVE, FL 2
Greensboro, NC 27403

Reassigned Medicare billing, North Carolina enrollment
Medicare enrollment name: Alliance Urology Specialists
30 clinicians in this Medicare group

NPI 1346204088 (336) 274-1114

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27403 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$125.01 typical visit price

range $54.12 – $165.09

Typical copayment $31.25 (range $13.53 – $41.27)

Most-billed visit code 99204

Established Patient

$67.72 typical visit price

range $17.21 – $134.61

Typical copayment $16.93 (range $4.30 – $33.65)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each A4351

DME-Orthotic Devices · category DF008N

3 suppliers12 claims2,910 services$1.45 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HOUSTON MAGILL KIMBROUGH JR. MD

Urology