KEAGHAN OTTENBAKER DO
NPI 1558987149
Family Medicine in Ada, MI
About Keaghan Ottenbaker Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KEAGHAN OTTENBAKER DO (NPI 1558987149) is an individual family medicine provider in Ada, Michigan, licensed in Michigan (5151014380) and active in the NPI registry since June 2020. She is enrolled in Medicare PECOS, is affiliated with Spectrum Health, and is a graduate of Other (2020).
NPPES Registry Identity
Specialties & Licenses
Accepted 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
Keaghan Ottenbaker 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.
Medicare Billing Reassignment
Medicare enrollment records show Keaghan Ottenbaker reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Grand Rapids, MI 49546
- Reassigned Medicare billing, Michigan enrollment
- 2,446 clinicians in this Medicare group
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 4
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.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Spectrum Health
Acute Care Hospitals · Grand Rapids, MIPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 49301 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
Other Providers at the Same Location NPPES 17
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Keaghan Ottenbaker's NPI number?
The NPI number for Keaghan Ottenbaker is 1558987149. It was assigned to this individual provider in the NPPES registry on June 19, 2020.
Where is Keaghan Ottenbaker located?
Keaghan Ottenbaker practices at 7128 Fulton St E, Ada, MI 49301. The listed phone number is (616) 825-3530.
What is Keaghan Ottenbaker's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Keaghan Ottenbaker enrolled in Medicare?
Yes. Keaghan Ottenbaker 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 organization bills Medicare for Keaghan Ottenbaker's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Keaghan Ottenbaker reassigns Medicare benefits to Spectrum Health Primary Care Partners (Grand Rapids, MI). The 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 Keaghan Ottenbaker's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Keaghan Ottenbaker accept?
Health plans from Priority Health list Keaghan Ottenbaker 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 Keaghan Ottenbaker affiliated with any hospitals?
According to CMS data, Keaghan Ottenbaker is affiliated with Spectrum Health.
When was this NPI record last updated?
The NPPES record for Keaghan Ottenbaker was last updated on September 6, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Keaghan Ottenbaker, DO · NPI 1558987149
Family Medicine physician in Ada, Michigan. Individual provider, active in the CMS NPPES registry since June 19, 2020.
## Identity
- **NPI:** 1558987149 (Entity type: Individual)
- **Enumerated:** June 19, 2020
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** 5151014380 (Michigan)
- **Sole proprietor:** No
## Practice location
- **Address:** 7128 FULTON ST E, Ada, MI 49301-8413
- **Phone:** (616) 825-3530
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Spectrum Health Primary Care Partners (NPI 1528374683, Grand Rapids, MI), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2020
## Record status
- **NPPES last updated:** September 6, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1558987149) · Data from the CMS NPPES public registry.