NOLAN ROBERT OTTO MD
NPI 1457053670
Radiology - Diagnostic Radiology in Jacksonville, FL

Q: What is Nolan Otto's NPI number?

The NPI number for Nolan Otto is 1457053670. It was assigned to this individual provider in the NPPES registry on March 21, 2023.

Q: What is Nolan Otto's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Q: When was this NPI record last updated?

The NPPES record for Nolan Otto was last updated on June 7, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 March 21, 2023PECOS Enrolled

4500 SAN PABLO RD S, JACKSONVILLE, FL 32224(904) 953-2000 Get Directions Write a Review

NPPES record last updated: June 7, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 7, 2024, Mar 21, 2023 (2 updates tracked since 2023).

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About Nolan Robert Otto Md NPPES

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

NOLAN ROBERT OTTO MD (NPI 1457053670) is an individual diagnostic radiology provider in Jacksonville, Florida, licensed in Florida (TRN38020) and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS and maintains a secondary practice location in Bradenton.

NPPES Registry Identity

NPI1457053670

Entity TypeIndividualMale

Primary Taxonomy2085R0202X

Provider Legal NameNOLAN ROBERT OTTOCredential: MD

Location Address4500 SAN PABLO RD SJacksonville, FL 32224-1865

Mailing Address4500 San Pablo Rd SJacksonville, FL 32224-1865 · (904) 953-2000

Phone(904) 953-2000

Sole ProprietorNo

Enumeration DateMarch 21, 2023

Last NPPES UpdateJune 7, 20242 updates tracked since enumeration

NPPES CertifiedJune 7, 2024

✔ NPI 1457053670 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians

Taxonomy Code2085R0202X

License✔ Licensed in FL · TRN38020

Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

4500 SAN PABLO RD S, Jacksonville, FL 32224

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Secondary Practice Location 1

Location 12020 59th St WBradenton, FL 34209-4604 · Phone (941) 567-2582

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nolan Robert Otto Md 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32224 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

$87.62 typical visit price

range $56.00 – $171.84

Typical copayment $21.90 (range $14.00 – $42.96)

Most-billed visit code 99203

Established Patient

$70.04 typical visit price

range $17.57 – $139.16

Typical copayment $17.51 (range $4.39 – $34.79)

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.

KATHERINE L WALSH PA-C/MPH

Physician Assistant