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DR. DIANA M OTTULICH MD
NPI 1629715552
Military Health Care Provider in Pearl Harbor, HI

Active since May 12, 2022PECOS Enrolled
822 CLARK ST, PEARL HARBOR, HI 96860(757) 836-5929 Get Directions Write a Review

NPPES record last updated: May 28, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 7, 2023, Sep 10, 2022, May 12, 2022 (3 updates tracked since 2022).

About Dr. Diana M Ottulich Md NPPES

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

DR. DIANA M OTTULICH MD (NPI 1629715552) is an individual military health care provider provider in Pearl Harbor, Hawaii, licensed in Virginia (0101280042) and active in the NPI registry since May 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1629715552
Entity TypeIndividualFemale
Primary Taxonomy171000000X
Provider Legal NameDR. DIANA M OTTULICHCredential: MD
Location Address822 CLARK STPearl Harbor, HI 96860-4652
Mailing Address822 Clark StPearl Harbor, HI 96860-4652
Phone(757) 836-5929
Sole ProprietorNo
Enumeration DateMay 12, 2022
Last NPPES UpdateMay 28, 20243 updates tracked since enumeration
NPPES CertifiedMay 28, 2024
✔ NPI 1629715552 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyMilitary Health Care ProviderOther Service Providers
Taxonomy Code171000000X
License✔ Licensed in VA · 0101280042
Definition
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
Also ListedGeneral PracticeTaxonomy 208D00000X · License 0101280042 (VA)
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
822 CLARK ST, Pearl Harbor, HI 96860
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Diana M Ottulich 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.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. MICHAEL JAMES HAUGHEY
Military Health Care Provider (Independent Duty Corpsman)
822 CLARK ST, SUITE 400
PEARL HARBOR, HI 96860
Honolulu County (808) 473-2899
CRAIG RANDOLPH SOLEIM NAVY IDC
Military Health Care Provider (Independent Duty Corpsman)
822 CLARK ST, NAVAL SUBMARINE SUPPORT COMMAND MEDICAL
PEARL HARBOR, HI 96860
Honolulu County (808) 473-2899
MR. MICHAEL GLEN PECK JR. IDC
Military Health Care Provider (Independent Duty Corpsman)
822 CLARK ST, SUITE 400
PEARL HARBOR, HI 96860
Honolulu County (808) 473-1094
MR. DAVID TERRANCE REPKING IDC
Technician, Other
822 CLARK ST, USS HONOLULU SSN718 SUITE 400
PEARL HARBOR, HI 96860
Honolulu County (808) 474-1128

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 Diana Ottulich's NPI number?

The NPI number for Diana Ottulich is 1629715552. It was assigned to this individual provider in the NPPES registry on May 12, 2022.

Where is Diana Ottulich located?

Diana Ottulich practices at 822 Clark St, Pearl Harbor, HI 96860. The listed phone number is (757) 836-5929.

What is Diana Ottulich's specialty?

The primary specialty registered for this NPI is Military Health Care Provider with taxonomy code 171000000X.

Is Diana Ottulich enrolled in Medicare?

Yes. Diana Ottulich is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Diana Ottulich was last updated on May 28, 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.