MARK A OTTO M.D.
NPI 1386794386
Hospitalist in Council Bluffs, IA

NPI Status: Active since January 11, 2007

Contact Information

800 MERCY DR
COUNCIL BLUFFS, IA
ZIP 51503
Phone: (855) 524-4001
Fax: (712) 325-2499

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  • Individual
  • Male
  • Hospitalist
  • Accepts Insurance
  • PECOS Enrolled

About MARK OTTO

This page provides the complete NPI Profile along with additional information for Mark Otto, a provider established in Council Bluffs, Iowa with a medical specialization in Hospitalist. The healthcare provider is registered in the NPI registry with number 1386794386 assigned on January 2007. The practitioner's primary taxonomy code is 208M00000X with license number MD-31413 (IA). The provider is registered as an individual and his NPI record was last updated 9 years ago.

NPI
1386794386
Provider Name
MARK A OTTO M.D.
Gender
Male
Entity Type
Individual
Location Address
800 MERCY DR COUNCIL BLUFFS, IA 51503
Location Phone
(855) 524-4001
Location Fax
(712) 325-2499
Mailing Address
800 MERCY DR COUNCIL BLUFFS, IA 51503
Mailing Phone
(855) 524-4001
Mailing Fax
(712) 325-2499
Is Sole Proprietor?
No
Enumeration Date
01-11-2007
Last Update Date
04-10-2017
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Hospitalist

Taxonomy Code
208M00000X
Type
Allopathic & Osteopathic Physicians
License No.
MD-31413
License State
IA
Taxonomy Description
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207Q00000XAllopathic & Osteopathic Physicians

Family Medicine

26689 (NE)
2207Q00000XAllopathic & Osteopathic Physicians

Family Medicine

31413 (IA)
3208M00000XAllopathic & Osteopathic Physicians

Hospitalist

26689 (NE)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Medica Insure Bronze $0 Copay PCP Visits - EPO
  • Medica Insure Bronze Premier - EPO
  • Medica Insure Bronze Share - EPO
  • Medica Insure Expanded Bronze Standard - EPO
  • Medica Insure Gold $0 Copay PCP Visits - EPO
  • Medica Insure Gold Share - EPO
  • Medica Insure Gold Standard - EPO
  • Medica Insure Silver $0 Copay PCP Visits - EPO
  • Medica Insure Silver Share - EPO
  • Medica Insure Silver Standard - EPO
  • Medica with CHI Health Bronze $0 Copay PCP Visits - EPO
  • Medica with CHI Health Bronze $0 Copay PCP Visits + Adult Eye Exam - EPO
  • Medica with CHI Health Bronze Premier - EPO
  • Medica with CHI Health Bronze Premier + Adult Eye Exam - EPO
  • Medica with CHI Health Bronze Share - EPO
  • Medica with CHI Health Bronze Share + Adult Eye Exam - EPO
  • Medica with CHI Health Expanded Bronze Standard - EPO
  • Medica with CHI Health Expanded Bronze Standard + Adult Eye Exam - EPO
  • Medica with CHI Health Gold $0 Copay PCP Visits - EPO
  • Medica with CHI Health Gold $0 Copay PCP Visits + Adult Eye Exam - EPO
  • Bronze Classic - EPO
  • Bronze Classic | with Bryan Health - EPO
  • Bronze Classic 4700 - EPO
  • Bronze Classic Standard - EPO
  • Bronze Classic Standard | with Bryan Health - EPO
  • Bronze Elite + PCP Saver Plus - EPO
  • Bronze Elite + PCP Saver Plus | with Bryan Health - EPO
  • Bronze Simple Diabetes - EPO
  • Bronze Simple Diabetes | with Bryan Health - EPO
  • Gold Classic Standard - EPO
  • Gold Classic Standard | with Bryan Health - EPO
  • Gold Elite - EPO
  • Gold Elite | with Bryan Health - EPO
  • Secure - EPO
  • Silver Classic - EPO
  • Silver Classic Standard - EPO
  • Silver Classic Standard | with Bryan Health - EPO
  • Silver Simple Diabetes - EPO
  • Silver Simple Diabetes | with Bryan Health - EPO
  • Silver Simple PCP Saver - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Mark Otto is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: No

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • DME-Oxygen and Supplies (DC000N)

    Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)

    3 DME suppliers used 23 Medicare Claims 23 Services Paid

  • DME-Oxygen and Supplies (DC002N)

    Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)

    3 DME suppliers used 25 Medicare Claims 25 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Follow-up hospital inpatient care per day, typically 25 minutes

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.

This service was performed 25 times for 15 patients

Follow-up hospital inpatient care per day, typically 35 minutes

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

This service was performed 265 times for 96 patients

Follow-up observation care per day, typically 35 minutes

Follow-up observation care is a daily check-up service that lasts about 35 minutes. It involves monitoring your health progress after a treatment or procedure. The care team assesses your recovery and addresses any concerns or questions you may have.

This service was performed 46 times for 36 patients

Hospital discharge day management, more than 30 minutes

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

This service was performed 63 times for 62 patients

Hospital observation care on day of discharge

Hospital observation care on the day of discharge involves monitoring your health status to ensure stability before you leave. This includes assessing vital signs, response to treatment, and readiness for home care or rehabilitation.

This service was performed 39 times for 38 patients

Initial hospital inpatient care per day, typically 70 minutes

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

This service was performed 34 times for 34 patients

Initial hospital observation care per day, typically 70 minutes

This service involves a healthcare professional closely monitoring your health condition during your hospital stay. It typically lasts for about 70 minutes each day. This helps in timely detection of any changes in your health, allowing for immediate response and treatment.

This service was performed 48 times for 48 patients

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 51503 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $122.23
  • Minimum New Patient Price $52.96
  • Maximum New Patient Price $161.4
  • Average New Patient Copayment $30.55
  • Minimum New Patient Copayment $13.24
  • Maximum New Patient Copayment $40.35

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $94.05
  • Minimum Established Patient Price $16.91
  • Maximum Established Patient Price $131.98
  • Average Established Patient Copayment $23.51
  • Minimum Established Patient Copayment $4.22
  • Maximum Established Patient Copayment $32.99

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1386794386, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 74. The final step is to find the difference between that total and the next multiple of ten (80 - 74 = 6).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
3
Unchanged
Pos 3
8
Doubled → 16 → 1 + 6
Pos 4
6
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
9
Unchanged
Pos 7
4
Doubled → 8
Pos 8
3
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
6
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 8 → 16 → 7 7 → 14 → 5 4 → 8 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 3 + 1 + 6 + 6 + 1 + 4 + 9 + 8 + 3 + 1 + 6 + 24 = 74

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 74 is 80. The difference is the calculated check digit.

80 - 74 = 6
This NPI is valid
The calculated check digit is 6, which matches the last digit of 1386794386.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Emergency Medicine
800 MERCY DR
COUNCIL BLUFFS, IA 51503
Emergency Medicine
800 MERCY DR
COUNCIL BLUFFS, IA 51503
Nurse Practitioner
800 MERCY DR
COUNCIL BLUFFS, IA 51503
Obstetrics & Gynecology
800 MERCY DR, SUITE 5
COUNCIL BLUFFS, IA 51503
Emergency Medicine
800 MERCY DR
COUNCIL BLUFFS, IA 51503
Specialist
800 MERCY DR, SUITE 110
COUNCIL BLUFFS, IA 51503
Internal Medicine (Hematology & Oncology)
800 MERCY DR, SUITE 10
COUNCIL BLUFFS, IA 51503
Dietitian, Registered
800 MERCY DR
COUNCIL BLUFFS, IA 51503
General Acute Care Hospital
800 MERCY DR
COUNCIL BLUFFS, IA 51503
Radiologic Technologist (Nuclear Medicine Technology)
800 MERCY DR
COUNCIL BLUFFS, IA 51503
Nurse Practitioner (Acute Care)
800 MERCY DR
COUNCIL BLUFFS, IA 51503
Surgery
800 MERCY DR
COUNCIL BLUFFS, IA 51503
Nurse Practitioner (Family)
800 MERCY DR, MERCY HOSPITAL ER
COUNCIL BLUFFS, IA 51503
Nurse Practitioner
800 MERCY DR
COUNCIL BLUFFS, IA 51503
Obstetrics & Gynecology
800 MERCY DR, SUITE 210
COUNCIL BLUFFS, IA 51503
Emergency Medicine
800 MERCY DR
COUNCIL BLUFFS, IA 51503
Emergency Medicine
800 MERCY DR
COUNCIL BLUFFS, IA 51503
Registered Nurse (Diabetes Educator)
800 MERCY DR, DIABETES EDUCATION DEPT
COUNCIL BLUFFS, IA 51503
Emergency Medicine
800 MERCY DR
COUNCIL BLUFFS, IA 51503
Family Medicine
800 MERCY DR, SUITE 120
COUNCIL BLUFFS, IA 51503

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1386794386, enumerated as an "individual" on January 11, 2007.

The provider is located at 800 MERCY DR COUNCIL BLUFFS, IA 51503 and the phone number is (855) 524-4001.

Hospitalist with taxonomy code 208M00000X.

The provider might be accepting Accepts: Medica and Oscar Insurance Company. Please consult your insurance carrier or call the provider to verify.