OTIS PERRY MAX INGERSOLL FNP
NPI 1386838407
Nurse Practitioner - Family in Albany, CA

Q: What is Otis Perry Ingersoll's NPI number?

The NPI number for Otis Perry Ingersoll is 1386838407. It was assigned to this individual provider in the NPPES registry on August 31, 2007. The provider is also known as Otis Perry Max Ingersoll Fnp.

Q: What is Otis Perry Ingersoll's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Active since August 31, 2007PECOS Enrolled

500 SAN PABLO AVE, ALBANY, CA 94706(510) 204-8130(510) 524-0861 Get Directions Write a Review

NPPES record last updated: February 10, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Feb 10, 2021, Oct 27, 2017 (2 updates tracked since 2017).

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About Otis Perry Max Ingersoll Fnp NPPES

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

OTIS PERRY MAX INGERSOLL FNP (NPI 1386838407) is an individual family provider in Albany, California, licensed in California (14774) and active in the NPI registry since August 2007. He is enrolled in Medicare PECOS and maintains a secondary practice location in Berkeley.

NPPES Registry Identity

NPI1386838407

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameOTIS PERRY MAX INGERSOLLCredential: FNP

Location Address500 SAN PABLO AVEAlbany, CA 94706-1103

Mailing Address500 San Pablo AveAlbany, CA 94706-1103 · (510) 204-8130 · Fax (510) 524-0861

Phone(510) 204-8130

Fax(510) 524-0861

Sole ProprietorNo

Enumeration DateAugust 31, 2007

Last NPPES UpdateFebruary 10, 20212 updates tracked since enumeration

NPPES CertifiedFebruary 10, 2021

✔ NPI 1386838407 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in CA · 14774

500 SAN PABLO AVE, Albany, CA 94706

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Other Names 1

Professional Name (2)Otis Perry Max Ingersoll Fnp

Secondary Practice Location 1

Location 12850 Telegraph Ave, #130Berkeley, CA 94705-1192 · Phone (510) 204-8110 · Fax (510) 843-0804

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Otis Perry Max Ingersoll Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Areas of Expertise CMS Part B claims 3

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.

134 services65 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

16 services13 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

14 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94706 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

$119.48 typical visit price

range $23.44 – $166.46

Typical copayment $29.87 (range $5.86 – $41.61)

Most-billed visit code 99214

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.

PRIMARY CARE AFFILIATES, INC.

Family Medicine

500 SAN PABLO AVE, SUITE 400
ALBANY, CA 94706

Alameda County (510) 524-4070

EVAN SCOTT COLLIER M.D.

Family Medicine

500 SAN PABLO AVE, SUITE 300
ALBANY, CA 94706

Alameda County (510) 204-8130

MISS PAMELA LEMMON BLAUFARB NP

Nurse Practitioner (Family)

500 SAN PABLO AVE, SUITE 400
ALBANY, CA 94706

Alameda County (415) 272-2058

MARGARET KIRKHAM RN, MSN, FNP

Nurse Practitioner (Family)

500 SAN PABLO AVE
ALBANY, CA 94706

Alameda County (510) 204-8130

MR. DREW HO NP-C

Nurse Practitioner (Family)

500 SAN PABLO AVE, SUITE 300
ALBANY, CA 94706

Alameda County (510) 204-8130

CORINA CLARK-DERMAN FNP

Nurse Practitioner (Family)

500 SAN PABLO AVE
ALBANY, CA 94706

Alameda County (510) 204-8130

ANDERSON HWA-TE TSAI D.O.

Internal Medicine

500 SAN PABLO AVE, STE 300
ALBANY, CA 94706

Alameda County (510) 204-8130

NINA R BIRNBAUM M.D.

Family Medicine

500 SAN PABLO AVE
ALBANY, CA 94706

Alameda County (510) 204-8130

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 Otis Perry Ingersoll's NPI number?

The NPI number for Otis Perry Ingersoll is 1386838407. It was assigned to this individual provider in the NPPES registry on August 31, 2007. The provider is also known as Otis Perry Max Ingersoll Fnp.

Where is Otis Perry Ingersoll located?

Otis Perry Ingersoll practices at 500 San Pablo Ave, Albany, CA 94706. The listed phone number is (510) 204-8130.

What is Otis Perry Ingersoll's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Otis Perry Ingersoll enrolled in Medicare?

Yes. Otis Perry Ingersoll is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Otis Perry Ingersoll was last updated on February 10, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.