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EDMOND L OTIS
NPI 1619681251
Marriage & Family Therapist in Moreno Valley, CA

Active since January 09, 2023PECOS Enrolled
26449 BODEGA CT, MORENO VALLEY, CA 92555(760) 612-7029 Get Directions Write a Review

NPPES record last updated: January 9, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Edmond L Otis NPPES

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

EDMOND L OTIS (NPI 1619681251) is an individual marriage & family therapist in Moreno Valley, California, licensed in California (31194) and active in the NPI registry since January 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1619681251
Entity TypeIndividualMale
Primary Taxonomy106H00000X
Provider Legal NameEDMOND L OTIS
Location Address26449 BODEGA CTMoreno Valley, CA 92555-2461
Mailing Address1242 University Ave Ste 6-570Riverside, CA 92507-8810 · (760) 612-7029
Phone(760) 612-7029
Sole ProprietorYes
Enumeration DateJanuary 9, 2023
NPPES CertifiedJanuary 9, 2023
✔ NPI 1619681251 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers
Taxonomy Code106H00000X
License✔ Licensed in CA · 31194
Definition
A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.
26449 BODEGA CT, Moreno Valley, CA 92555
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Edmond L Otis 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.

Medicare Billing Reassignments

2

Medicare enrollment records show Edmond Otis reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Grow Healthcare Group PC
353 mi
Mental Health
99 S ALMADEN BLVD STE 600
San Jose, CA 95113
  • Reassigned Medicare billing, California enrollment
  • 3,139 clinicians in this Medicare group
NPI 1154994846 (408) 402-4385
Grow Healthcare Group PA
2,279 mi
Mental Health
66 W FLAGLER ST STE 900
Miami, FL 33130
  • Reassigned Medicare billing, District of Columbia and Florida enrollments
  • 1,424 clinicians in this Medicare group
NPI 1245845932 (786) 244-7711

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Edmond Otis's NPI number?

The NPI number for Edmond Otis is 1619681251. It was assigned to this individual provider in the NPPES registry on January 9, 2023.

Where is Edmond Otis located?

Edmond Otis practices at 26449 Bodega Ct, Moreno Valley, CA 92555. The listed phone number is (760) 612-7029.

What is Edmond Otis's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Is Edmond Otis enrolled in Medicare?

Yes. Edmond Otis is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Edmond Otis's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Edmond Otis reassigns Medicare benefits to 2 organizations: Grow Healthcare Group PC (San Jose, CA) and Grow Healthcare Group PA (Miami, FL). Each 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 Edmond Otis's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Edmond Otis was last updated on January 9, 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.