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RYAN DAVID OTTO PA
NPI 1174845226
Physician Assistant in Oakland, CA

Active since February 17, 2010PECOS EnrolledAccepts Medicare Assignment
275 W MACARTHUR BLVD, SUITE 17, OAKLAND, CA 94611(510) 752-1155 Get Directions Write a Review

NPPES record last updated: January 3, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Ryan David Otto Pa NPPES

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

RYAN DAVID OTTO PA (NPI 1174845226) is an individual physician assistant in Oakland, California, licensed in California (PA20845) and active in the NPI registry since February 2010. He is enrolled in Medicare PECOS and is a graduate of Other (2009).

NPPES Registry Identity

NPI1174845226
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameRYAN DAVID OTTOCredential: PA
Location Address275 W MACARTHUR BLVD, SUITE 17Oakland, CA 94611-5641
Mailing Address275 W Macarthur Blvd, Suite 17Oakland, CA 94611-5641 · (650) 823-9384
Phone(510) 752-1155
Sole ProprietorNo
Medical School CMSOtherGraduated 2009
Enumeration DateFebruary 17, 2010
Last NPPES UpdateJanuary 3, 2022
✔ NPI 1174845226 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in CA · PA20845
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
275 W MACARTHUR BLVD, Oakland, CA 94611
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ryan David Otto Pa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6002081429
PECOS Enrollment IDI20111214000447
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94611 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
$104.51 typical visit price
range $69.00 – $202.35
Typical copayment $26.12 (range $17.25 – $50.58)
Most-billed visit code 99203
Established Patient
$84.91 typical visit price
range $23.44 – $166.46
Typical copayment $21.22 (range $5.86 – $41.61)
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 20

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

DR. ANNA C. MORGAN MD
Specialist
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (510) 752-1000
DR. TRANG H. LA MD
Radiology (Radiation Oncology)
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (510) 752-1000
DR. AMIN MATIN M.D., M.P.H.
Radiology (Diagnostic Radiology)
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (925) 295-5758
SUCHETA KORWAR MD
Student in an Organized Health Care Education/Training Program
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (510) 752-1000
MR. MATTHEW GABRIELSON D.P.T.
Physical Therapist (Orthopedic)
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (510) 752-6221
MALORIE HACKER MD
Student in an Organized Health Care Education/Training Program
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (510) 752-1000
RENEE L. PERRY DO
Obstetrics & Gynecology
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (510) 752-1000
HERPRIT KAUR MAHAL MD
Hospitalist
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (510) 752-1000

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 Ryan Otto's NPI number?

The NPI number for Ryan Otto is 1174845226. It was assigned to this individual provider in the NPPES registry on February 17, 2010.

Where is Ryan Otto located?

Ryan Otto practices at 275 W Macarthur Blvd Suite 17, Oakland, CA 94611. The listed phone number is (510) 752-1155.

What is Ryan Otto's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Ryan Otto enrolled in Medicare?

Yes. Ryan Otto is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Ryan Otto was last updated on January 3, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.