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MIRA OTTO M.D.
NPI 1851719553
Internal Medicine in Ann Arbor, MI

Active since April 01, 2014PECOS Enrolled
2215 FULLER RD, ANN ARBOR, MI 48105(734) 845-5500 Get Directions Write a Review

NPPES record last updated: March 10, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 10, 2026, Oct 20, 2020 (2 updates tracked since 2020).

About Mira Otto M.d. NPPES

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

MIRA OTTO M.D. (NPI 1851719553) is an individual internal medicine provider in Ann Arbor, Michigan, licensed in Michigan (4301105094) and active in the NPI registry since April 2014. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1851719553
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameMIRA OTTOCredential: M.D.
Location Address2215 FULLER RDAnn Arbor, MI 48105-2303
Mailing Address2215 Fuller RdAnn Arbor, MI 48105-2303 · (734) 845-5500
Phone(734) 845-5500
Sole ProprietorNo
Enumeration DateApril 1, 2014
Last NPPES UpdateMarch 10, 20262 updates tracked since enumeration
NPPES CertifiedMarch 10, 2026
✔ NPI 1851719553 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in MI · 4301105094
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
2215 FULLER RD, Ann Arbor, MI 48105
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Other Names 1

Former Name (1)Mira Samet M.d.

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mira Otto M.d. 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 Reassignment

Medicare enrollment records show Mira Otto reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Henry Ford Health System
33 mi
Pediatrics
2799 W GRAND BLVD
Detroit, MI 48202
  • Reassigned Medicare billing, Michigan enrollment
  • 1,886 clinicians in this Medicare group
NPI 1003990318 (313) 916-2600

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48105 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
$134.28 typical visit price
range $58.04 – $177.36
Typical copayment $33.57 (range $14.51 – $44.34)
Most-billed visit code 99204
Established Patient
$102.35 typical visit price
range $18.32 – $143.49
Typical copayment $25.58 (range $4.58 – $35.87)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
4 suppliers11 claims56 services$6.97 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
3 suppliers12 claims28 services$0.86 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

MS. CONSTANCE LAROSA RN
Registered Nurse
2215 FULLER RD
ANN ARBOR, MI 48105
Washtenaw County (734) 769-7100
THOMAS F CURRAN
Anesthesiology
2215 FULLER RD
ANN ARBOR, MI 48105
Washtenaw County (734) 845-5342
MRS. NICHELLE BOWMAN RN
Registered Nurse
2215 FULLER RD, RADIATION ONCOLOGY 114B
ANN ARBOR, MI 48105
Washtenaw County (734) 845-3914
MRS. CAREY ANN MICHEL RN
Registered Nurse
2215 FULLER RD
ANN ARBOR, MI 48105
Washtenaw County (734) 222-4230
JACQUELYN VANZILE LPCC
Counselor (Mental Health)
2215 FULLER RD
ANN ARBOR, MI 48105
Washtenaw County (734) 769-7100
CARRIE JO HERNANDEZ RN
Registered Nurse
2215 FULLER RD
ANN ARBOR, MI 48105
Washtenaw County (734) 845-5598
ERIC PATTERSON PTA
Physical Therapy Assistant
2215 FULLER RD
ANN ARBOR, MI 48105
Washtenaw County (734) 845-3829
MS. AMIE RICHARDSON
Physical Therapy Assistant
2215 FULLER RD
ANN ARBOR, MI 48105
Washtenaw County (734) 769-7100

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 Mira Otto's NPI number?

The NPI number for Mira Otto is 1851719553. It was assigned to this individual provider in the NPPES registry on April 1, 2014. The provider is also known as Mira Samet M.D..

Where is Mira Otto located?

Mira Otto practices at 2215 Fuller Rd, Ann Arbor, MI 48105. The listed phone number is (734) 845-5500.

What is Mira Otto's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Mira Otto enrolled in Medicare?

Yes. Mira Otto is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Mira Otto's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mira Otto reassigns Medicare benefits to Henry Ford Health System (Detroit, 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 Mira Otto'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 Mira Otto was last updated on March 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.