EDWARD BRIAN ORTELL DO
NPI 1346236940
Surgery in Ottumwa, IA

Q: What is Edward Ortell's NPI number?

The NPI number for Edward Ortell is 1346236940. It was assigned to this individual provider in the NPPES registry on September 20, 2005.

Q: What is Edward Ortell's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Q: When was this NPI record last updated?

The NPPES record for Edward Ortell was last updated on January 9, 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.

Active since September 20, 2005PECOS EnrolledAccepts Medicare Assignment

75/100

CMS Quality Rating

1005 PENNSYLVANIA AVE, OTTUMWA, IA 52501(641) 684-2927(641) 684-2926 Get Directions Write a Review

NPPES record last updated: January 9, 2017. Verified against the NPPES registry weekly; last sync: November 01, 2026.

On this page

About Edward Brian Ortell Do NPPES

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

EDWARD BRIAN ORTELL DO (NPI 1346236940) is an individual surgery provider in Ottumwa, Iowa, licensed in Iowa (3557) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS, is affiliated with Ottumwa Regional Health Center, and is a graduate of Des Moines University Of Osteopathic Medicine And Health Sciences (1995).

NPPES Registry Identity

NPI1346236940

Entity TypeIndividualMale

Primary Taxonomy208600000X

Provider Legal NameEDWARD BRIAN ORTELLCredential: DO

Location Address1005 PENNSYLVANIA AVEOttumwa, IA 52501-6413

Mailing Address1005 Pennsylvania AveOttumwa, IA 52501-6413 · (641) 684-2927 · Fax (641) 684-2926

Phone(641) 684-2927

Fax(641) 684-2926

Sole ProprietorNo

Medical School CMSDes Moines University Of Osteopathic Medicine And Health SciencesGraduated 1995

Enumeration DateSeptember 20, 2005

Last NPPES UpdateJanuary 9, 2017

✔ NPI 1346236940 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208600000X

License✔ Licensed in IA · 3557

Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Also ListedColon & Rectal SurgeryTaxonomy 208C00000X · License 3557 (IA)

1005 PENNSYLVANIA AVE, Ottumwa, IA 52501

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Other Identifiers 8

Other212484IA · Ia Health Solutions

Other34520IA · Wellmark Inc Bcbs Of Ia

Medicare UPINH25699

OtherP00052611IA · Railroad Medicare

Medicaid1267864IA

Other420681060B5IA · John Deere Health

OtherH005IA · Triwest

Medicare ID-Type UnspecifiedI10034

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Edward Brian Ortell Do 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 ID8123914827

PECOS Enrollment IDI20040227000242

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 Reassignments

Medicare enrollment records show Edward Ortell reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Ottumwa Health Group LLC

0.2 mi

Gynecology

1001 PENNSYLVANIA AVE
Ottumwa, IA 52501

Reassigned Medicare billing, Iowa enrollment
86 clinicians in this Medicare group

NPI 1386956290 (641) 682-7511

Jefferson County Hospital

3.1 mi

Family Medicine

1000 WILDWOOD DR STE 1
Ottumwa, IA 52501

Reassigned Medicare billing, Iowa enrollment
Also billed through NPI 1376648329 (Iowa)
79 clinicians in this Medicare group

NPI 1053284299 (641) 472-4111

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 17

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 low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

179 services145 patients

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

92 services43 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

57 services52 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

47 services46 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

43 services40 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

40 services40 patients

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.

40 services38 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

39 services38 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.

27 services27 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

23 services12 patients

Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, less than 3.0 cm 43249

This procedure involves using a flexible tube with a camera, called an endoscope, to gently expand narrowed areas in your esophagus, stomach, or upper small bowel. A small balloon is inflated, making it easier for food and liquid to pass through. It's safe and effective.

18 services17 patients

Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk G0121

Colorectal cancer screening, such as a colonoscopy, is a preventive measure to detect early signs of cancer in the large intestine. For individuals not at high risk, it's typically recommended at age 50. A small, flexible tube with a camera is used to examine your colon. It's a safe, effective way to catch issues early.

17 services17 patients

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

14 services14 patients

Diagnostic exam of large bowel using a flexible endoscope 45378

This procedure, known as a colonoscopy, involves using a flexible tube with a light and camera to examine the large intestine. It helps detect any abnormalities such as polyps or inflammation. It's a standard procedure to ensure gut health.

12 services12 patients

Removal of tunneled central venous tube 36589

A tunneled central venous tube removal is a procedure to take out a long, thin tube that was previously placed in a large vein in your body. This tube helps deliver medication or nutrition. The removal is usually quick and done under local anesthesia.

11 services11 patients

Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221

Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.

11 services11 patients

Colorectal cancer screening; colonoscopy on individual at high risk G0105

Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.

11 services11 patients

Hospital Affiliations CMS Care Compare 5

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

Ottumwa Regional Health Center

Acute Care Hospitals · Ottumwa, IA

2/5 CMS rating

OwnershipProprietary

CMS Certification Number160089

Location1001 E PennsylvaniaOttumwa, IA 52501 · Wapello County

Emergency services Birthing friendly

Washington County Hospital And Clinics

Critical Access Hospitals · Washington, IA

OwnershipGovernment - Local

CMS Certification Number161344

Location400 East Polk StreetWashington, IA 52353 · Washington County

Emergency services

Jefferson County Health Center

Critical Access Hospitals · Fairfield, IA

OwnershipGovernment - Local

CMS Certification Number161364

Location2000 S MainFairfield, IA 52556 · Jefferson County

Emergency services

Pella Regional Health Center

Critical Access Hospitals · Pella, IA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number161367

Location404 Jefferson StreetPella, IA 50219 · Marion County

Emergency services Birthing friendly

Mahaska Health Partnership

Critical Access Hospitals · Oskaloosa, IA

4/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number161379

Location1229 C Avenue EastOskaloosa, IA 52577 · Mahaska County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 52501 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

$81.84 typical visit price

range $52.96 – $161.40

Typical copayment $20.46 (range $13.24 – $40.35)

Most-billed visit code 99203

Established Patient

$66.36 typical visit price

range $16.91 – $131.98

Typical copayment $16.59 (range $4.22 – $32.99)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

75/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Reported Quality Measures

Care Plan

Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…

23%511 patients1/55-star benchmark: 100%

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

100%2,957 patients5/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

98%1,275 patients4/55-star benchmark: 99%

Health Information Exchange

The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…

77%145 patients4/55-star benchmark: 88%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

100%1,364 patients5/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

22%1,567 patients1/55-star benchmark: 97%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

22%1,365 patients1/55-star benchmark: 97%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user

Patients screenedForUse: 96% · 874 patients

Patients tobacco: 7% · 42 patients

77%506 patients4/55-star benchmark: 98%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

68%1,567 patients3/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…

8%1,567 patients1/55-star benchmark: 89%

View, Download, or Transmit (VDT)

At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.

13%1,567 patients

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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. NORMAN RUSH HUTCHISON M.D.

Ophthalmology

1005 PENNSYLVANIA AVE, SUITE 110
OTTUMWA, IA 52501

Wapello County (641) 682-8571

THOMAS H HOSKINS PA

Physician Assistant

1005 PENNSYLVANIA AVE, SUITE 212
OTTUMWA, IA 52501

Wapello County (641) 682-5443

DONALD D BERG MD PC

Specialist

1005 PENNSYLVANIA AVE, SUITE 212
OTTUMWA, IA 52501

Wapello County (641) 682-5443

OTTUMWA HEALTH GROUP LLC

Obstetrics & Gynecology

1005 PENNSYLVANIA AVE, STE 204
OTTUMWA, IA 52501

Wapello County (641) 682-8761

ELVIN W MCCARL M.D.

Radiology (Diagnostic Radiology)

1005 PENNSYLVANIA AVE, SUITE 103
OTTUMWA, IA 52501

Wapello County (641) 682-5453

MICHAEL T SHAEFFER MD PC

Urology

1005 PENNSYLVANIA AVE, #208
OTTUMWA, IA 52501

Wapello County (641) 682-5481

FOREFRONT DERMATOLOGY, S.C.

Dermatology

1005 PENNSYLVANIA AVE, SUITE 210
OTTUMWA, IA 52501

Wapello County (641) 683-3195

STANLEY A BLEW MD

Internal Medicine

1005 PENNSYLVANIA AVE, SUITE 104
OTTUMWA, IA 52501

Wapello County (641) 682-4594

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 Edward Ortell's NPI number?

The NPI number for Edward Ortell is 1346236940. It was assigned to this individual provider in the NPPES registry on September 20, 2005.

Where is Edward Ortell located?

Edward Ortell practices at 1005 Pennsylvania Ave, Ottumwa, IA 52501. The listed phone number is (641) 684-2927.

What is Edward Ortell's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Edward Ortell enrolled in Medicare?

Yes. Edward Ortell 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.

Which organizations bill Medicare for Edward Ortell's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Edward Ortell reassigns Medicare benefits to 2 organizations: Ottumwa Health Group LLC (Ottumwa, IA) and Jefferson County Hospital (Ottumwa, IA). Each 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 Edward Ortell's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Edward Ortell accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan and Wellmark Health Plan of Iowa, Inc. list Edward Ortell as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Edward Ortell affiliated with any hospitals?

According to CMS data, Edward Ortell is affiliated with Ottumwa Regional Health Center, Washington County Hospital And Clinics, Jefferson County Health Center, Pella Regional Health Center and Mahaska Health Partnership.

When was this NPI record last updated?

The NPPES record for Edward Ortell was last updated on January 9, 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.