MR. BRYAN DAVID OTLEY PA-C
NPI 1508671066
Physician Assistant in Jackson, MS

Q: What is Bryan Otley's NPI number?

The NPI number for Bryan Otley is 1508671066. It was assigned to this individual provider in the NPPES registry on February 11, 2025.

Q: What is Bryan Otley's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Bryan Otley was last updated on March 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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 February 11, 2025PECOS EnrolledAccepts Medicare Assignment

1325 E FORTIFICATION ST, JACKSON, MS 39202(601) 354-4488(601) 351-5980 Get Directions Write a Review

NPPES record last updated: March 9, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 9, 2026, Feb 18, 2025, Feb 11, 2025 (3 updates tracked since 2025).

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About Mr. Bryan David Otley Pa-c NPPES

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

MR. BRYAN DAVID OTLEY PA-C (NPI 1508671066) is an individual physician assistant in Jackson, Mississippi and active in the NPI registry since February 2025. He is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1508671066

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameMR. BRYAN DAVID OTLEYCredential: PA-C

Location Address1325 E FORTIFICATION STJackson, MS 39202-2442

Mailing Address1325 E Fortification StJackson, MS 39202-2442 · (601) 354-4488 · Fax (601) 351-5980

Phone(601) 354-4488

Fax(601) 351-5980

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateFebruary 11, 2025

Last NPPES UpdateMarch 9, 20263 updates tracked since enumeration

NPPES CertifiedMarch 9, 2026

✔ NPI 1508671066 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

1325 E FORTIFICATION ST, Jackson, MS 39202

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Bryan David Otley Pa-c 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 ID2567945850

PECOS Enrollment IDI20260315000007

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 39202 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

$80.50 typical visit price

range $51.65 – $159.18

Typical copayment $20.12 (range $12.91 – $39.79)

Most-billed visit code 99203

Established Patient

$64.96 typical visit price

range $16.15 – $129.61

Typical copayment $16.24 (range $4.03 – $32.40)

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.

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