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OTHON WILTZ M.D.
NPI 1174525869
Colon & Rectal Surgery in Fairfax, VA

Active since August 11, 2005PECOS Enrolled
3620 JOSEPH SIEWICK DR STE 406, FAIRFAX, VA 22033(703) 359-8640(703) 591-6105 Get Directions Write a Review

NPPES record last updated: July 25, 2017. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Othon Wiltz M.d. NPPES

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

OTHON WILTZ M.D. (NPI 1174525869) is an individual colon & rectal surgery provider in Fairfax, Virginia, licensed in Virginia (0101240155) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS, is affiliated with Montefiore Medical Center, and is a graduate of Columbia University College Of Physicians And Surgeons (1985).

NPPES Registry Identity

NPI1174525869
Entity TypeIndividualMale
Primary Taxonomy208C00000X
Provider Legal NameOTHON WILTZCredential: M.D.
Location Address3620 JOSEPH SIEWICK DR STE 406Fairfax, VA 22033-1761
Mailing Address3620 Joseph Siewick Dr, Suite 406Fairfax, VA 22033 · (703) 359-8640 · Fax (703) 591-6105
Phone(703) 359-8640
Fax(703) 591-6105
Sole ProprietorNo
Medical School CMSColumbia University College Of Physicians And SurgeonsGraduated 1985
Enumeration DateAugust 11, 2005
Last NPPES UpdateJuly 25, 2017
✔ NPI 1174525869 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyColon & Rectal SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208C00000X
Licenses✔ Licensed in VA · 0101240155✔ Licensed in PR · 11687
Definition
A colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease.
3620 JOSEPH SIEWICK DR STE 406, Fairfax, VA 22033
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Other Identifiers 9

Medicaid1174525869VA
Other601049PR · Mmm
OtherSE4019PR · Palic
Other7113PR · Imc
Other060957PR · La Cruz Azul
Other89937PR · Sss
Other1400005PR · Humana
Other311678PR · Cigna
Medicare UPINF50723PR

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Othon Wiltz M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2163329673
PECOS Enrollment IDI20200323002387
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 Othon Wiltz reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Montefiore Medical Center
224 mi
Family Medicine
2633 BROADWAY
New York, NY 10025
  • Reassigned Medicare billing, New York enrollment
  • 5,251 clinicians in this Medicare group
NPI 1760288278 (888) 663-6331

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

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
43 services25 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
14 services14 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Montefiore Medical Center

Acute Care Hospitals · Bronx, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330059
Location111 East 210th StreetBronx, NY 10467 · Bronx County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 22033 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
$100.31 typical visit price
range $65.18 – $194.86
Typical copayment $25.07 (range $16.29 – $48.71)
Most-billed visit code 99203
Established Patient
$80.66 typical visit price
range $21.40 – $158.88
Typical copayment $20.16 (range $5.35 – $39.72)
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.

Other Providers at the Same Location NPPES 3

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

CHRISTINE A GILLOON RD
Dietitian, Registered
3620 JOSEPH SIEWICK DR STE 406
FAIRFAX, VA 22033
Fairfax County (703) 359-8640
ANAND NATH MD
Internal Medicine (Gastroenterology)
3620 JOSEPH SIEWICK DR STE 406
FAIRFAX, VA 22033
Fairfax County (703) 391-3955
MONA ABED FNP-BC
Nurse Practitioner (Family)
3620 JOSEPH SIEWICK DR STE 406
FAIRFAX, VA 22033
Fairfax County (844) 466-8244

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Othon Wiltz's NPI number?

The NPI number for Othon Wiltz is 1174525869. It was assigned to this individual provider in the NPPES registry on August 11, 2005.

Where is Othon Wiltz located?

Othon Wiltz practices at 3620 Joseph Siewick Dr Ste 406, Fairfax, VA 22033. The listed phone number is (703) 359-8640.

What is Othon Wiltz's specialty?

The primary specialty registered for this NPI is Colon & Rectal Surgery with taxonomy code 208C00000X.

Is Othon Wiltz enrolled in Medicare?

Yes. Othon Wiltz is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Othon Wiltz's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Othon Wiltz reassigns Medicare benefits to Montefiore Medical Center (New York, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Othon Wiltz's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Othon Wiltz affiliated with any hospitals?

According to CMS data, Othon Wiltz is affiliated with Montefiore Medical Center.

When was this NPI record last updated?

The NPPES record for Othon Wiltz was last updated on July 25, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.