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RANDALL JASON OTTO M.D.
NPI 1841494689
Orthopaedic Surgery in Fenton, MO

Active since June 14, 2007PECOS EnrolledAccepts Medicare Assignment
81.57/100
CMS Quality Rating
1011 BOWLES AVE STE 400, FENTON, MO 63026(314) 977-7200(636) 326-6533 Get Directions Write a Review

NPPES record last updated: February 24, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 24, 2021, Jul 18, 2019, Jan 10, 2019 (3 updates tracked since 2019).

About Randall Jason Otto M.d. NPPES

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

RANDALL JASON OTTO M.D. (NPI 1841494689) is an individual orthopaedic surgery provider in Fenton, Missouri, licensed in Missouri (2012011162) and active in the NPI registry since June 2007. He is enrolled in Medicare PECOS, is affiliated with Ssm St Joseph Health Center, and is a graduate of University Of Missouri, Kansas City, School Of Medicine (2005).

NPPES Registry Identity

NPI1841494689
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameRANDALL JASON OTTOCredential: M.D.
Location Address1011 BOWLES AVE STE 400Fenton, MO 63026-2387
Mailing Address1008 S Spring Ave Fl 1Saint Louis, MO 63110-2520 · (314) 977-5350 · Fax (314) 977-1629
Phone(314) 977-7200
Fax(636) 326-6533
Sole ProprietorNo
Medical School CMSUniversity Of Missouri, Kansas City, School Of MedicineGraduated 2005
Enumeration DateJune 14, 2007
Last NPPES UpdateFebruary 24, 20213 updates tracked since enumeration
NPPES CertifiedFebruary 24, 2021
✔ NPI 1841494689 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
License✔ Licensed in MO · 2012011162
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
1011 BOWLES AVE STE 400, Fenton, MO 63026
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Other Identifiers 6

OtherA82171MO · Healthlink
Other4258558MO · Cigna
Other771091MO · Anthem Blue Cross Blue Shield
Other122950063MO · Medicare Ptan
Other136637MO · Healthcare Usa
Medicaid501357701MO

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan 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

Randall Jason Otto M.d. 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 ID3173792801
PECOS Enrollment IDI20120813000638
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.

Areas of Expertise CMS Part B claims 8

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.

Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
245 services152 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
180 services148 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
104 services98 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
92 services92 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
66 services62 patients
Prosthetic repair of shoulder joint, total shoulder 23472
Total shoulder prosthetic repair is a surgical procedure to replace a damaged shoulder joint with artificial components. It aims to relieve pain and restore mobility. The procedure involves replacing the ball (humeral head) and socket (glenoid) of the shoulder joint.
51 services50 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Ssm St Joseph Health Center

Acute Care Hospitals · Saint Charles, MO
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number260005
Location300 1st Capitol DrSaint Charles, MO 63301 · St. Charles County
Emergency services

Mercy Hospital South

Acute Care Hospitals · Saint Louis, MO
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number260077
Location10010 Kennerly RoadSaint Louis, MO 63128 · St. Louis County
Emergency services

Ssm St Clare Health Center

Acute Care Hospitals · Fenton, MO
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number260081
Location1015 BowlesFenton, MO 63026 · Jefferson County
Emergency services Birthing friendly

Ssm Health St Mary's Hospital - St Louis

Acute Care Hospitals · Richmond Heights, MO
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number260091
Location6420 Clayton RdRichmond Heights, MO 63117 · St. Louis County
Emergency services Birthing friendly

Washington County Memorial Hospital

Critical Access Hospitals · Potosi, MO
OwnershipGovernment - Local
CMS Certification Number261308
Location300 Health WayPotosi, MO 63664 · Washington County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63026 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
$86.32 typical visit price
range $55.65 – $169.38
Typical copayment $21.58 (range $13.91 – $42.34)
Most-billed visit code 99203
Established Patient
$69.50 typical visit price
range $17.76 – $137.92
Typical copayment $17.37 (range $4.44 – $34.48)
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.

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.

81.57/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality76.09
Promoting Interoperability100
Improvement Activities40
Cost54.28

Reported Quality Measures

Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
95%3,059 patients4/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
92%499 patients4/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
75%704 patients4/55-star benchmark: 99%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
94%704 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
96%1,798 patients4/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
55%704 patients3/55-star benchmark: 90%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
35%1,641 patients2/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 94% · 1,169 patients
Patients tobacco: 31% · 152 patients
85%1,169 patients4/55-star benchmark: 98%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
53%1,798 patients3/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
13%1,798 patients1/55-star benchmark: 79%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 704 patients
2%704 patients4/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES

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

MRS. KAILEY JEAN MCCUTCHEN NP
Nurse Practitioner (Family)
1011 BOWLES AVE STE 400
FENTON, MO 63026
St. Louis County (314) 617-2970

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 Randall Otto's NPI number?

The NPI number for Randall Otto is 1841494689. It was assigned to this individual provider in the NPPES registry on June 14, 2007.

Where is Randall Otto located?

Randall Otto practices at 1011 Bowles Ave Ste 400, Fenton, MO 63026. The listed phone number is (314) 977-7200.

What is Randall Otto's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Randall Otto enrolled in Medicare?

Yes. Randall Otto 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.

What insurance does Randall Otto accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health and Ambetter from Sunflower Health Plan and 4 other insurers list Randall Otto 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 Randall Otto affiliated with any hospitals?

According to CMS data, Randall Otto is affiliated with Ssm St Joseph Health Center, Mercy Hospital South, Ssm St Clare Health Center, Ssm Health St Mary's Hospital - St Louis and Washington County Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Randall Otto was last updated on February 24, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.