LARRY D OTTE D.M.D.
NPI 1194859355
Dentist - Oral and Maxillofacial Surgery in Peoria, IL
About Larry D Otte D.m.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LARRY D OTTE D.M.D. (NPI 1194859355) is an individual oral and maxillofacial surgery provider in Peoria, Illinois, licensed in Illinois (021-001850) and active in the NPI registry since March 2007. He has opted out of Medicare through December 19, 2027 and remains eligible to order and refer.
NPPES Registry Identity
Specialties & Licenses 2
Other Identifiers 3
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Larry D Otte D.m.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from December 19, 2017 through December 19, 2027.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 61604 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
PEORIA, IL 61604
PEORIA, IL 61604
PEORIA, IL 61604
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 Larry Otte's NPI number?
The NPI number for Larry Otte is 1194859355. It was assigned to this individual provider in the NPPES registry on March 16, 2007.
Where is Larry Otte located?
Larry Otte practices at 2807 N Knoxville Ave, Peoria, IL 61604. The listed phone number is (309) 682-1213.
What is Larry Otte's specialty?
The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.
Is Larry Otte enrolled in Medicare?
No. Larry Otte has opted out of Medicare through December 19, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.
When was this NPI record last updated?
The NPPES record for Larry Otte was last updated on October 2, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.
# Larry D Otte, D.M.D. · NPI 1194859355
Oral and Maxillofacial Surgery provider in Peoria, Illinois. Individual provider, active in the CMS NPPES registry since March 16, 2007.
## Identity
- **NPI:** 1194859355 (Entity type: Individual)
- **Enumerated:** March 16, 2007
- **Primary specialty:** Dentist - Oral and Maxillofacial Surgery · taxonomy 1223S0112X
- **State license:** 021-001850 (Illinois)
- **Sole proprietor:** No
## Practice location
- **Address:** 2807 N KNOXVILLE AVE, Peoria, IL 61604-2869
- **Phone:** (309) 682-1213
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through December 19, 2027); services are provided under private contract
## Record status
- **NPPES last updated:** October 2, 2008
- **Other identifiers:** Other 909830 (IL); Medicare UPIN U67952 (IL); Medicare ID-Type Unspecified L61778 (IL)
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Source: [NPI Profile](https://npiprofile.com/npi/1194859355) · Data from the CMS NPPES public registry.