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RANDOLPH OTTO MD
NPI 1881767606
Radiology - Pediatric Radiology in Tacoma, WA

Active since November 17, 2006PECOS EnrolledAccepts Medicare Assignment
2202 S CEDAR ST STE 200, TACOMA, WA 98405(253) 383-1099(253) 383-3919 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Randolph Otto Md NPPES

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

RANDOLPH OTTO MD (NPI 1881767606) is an individual pediatric radiology provider in Tacoma, Washington, licensed in Washington (00027380) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS and is a graduate of University Of Michigan Medical School (1985).

NPPES Registry Identity

NPI1881767606
Entity TypeIndividualMale
Primary Taxonomy2085P0229X
Provider Legal NameRANDOLPH OTTOCredential: MD
Location Address2202 S CEDAR ST STE 200Tacoma, WA 98405-2318
Mailing Address3402 S 18th StTacoma, WA 98405-1903
Phone(253) 383-1099
Fax(253) 383-3919
Sole ProprietorNo
Medical School CMSUniversity Of Michigan Medical SchoolGraduated 1985
Enumeration DateNovember 17, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1881767606 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Pediatric RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085P0229X
License✔ Licensed in WA · 00027380
Definition
A radiologist who is proficient in all forms of diagnostic imaging as it pertains to the treatment of diseases in the newborn, infant, child and adolescent. This specialist has knowledge of both imaging and interventional procedures related to the care and management of diseases of children. A pediatric radiologist must be highly knowledgeable of all organ systems as they relate to growth and development, congenital malformations, diseases peculiar to infants and children and diseases that begin in childhood but cause substantial residual impairment in adulthood.
2202 S CEDAR ST STE 200, Tacoma, WA 98405
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Other Identifiers 4

Medicaid8125395WA
Medicare UPINE09058WA
Medicare ID-Type UnspecifiedOO1055620WA · Tacoma Radiological Assoc
Medicare ID-Type UnspecifiedAB01917WA · Union Avenue Open Mri

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska.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

Randolph Otto Md 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 ID9739178096
PECOS Enrollment IDI20040511000820
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

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

DR. BRYCE BUNN DO
Surgery
2202 S CEDAR ST STE 200
TACOMA, WA 98405
Pierce County (253) 301-5280

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 Randolph Otto's NPI number?

The NPI number for Randolph Otto is 1881767606. It was assigned to this individual provider in the NPPES registry on November 17, 2006.

Where is Randolph Otto located?

Randolph Otto practices at 2202 S Cedar St Ste 200, Tacoma, WA 98405. The listed phone number is (253) 383-1099.

What is Randolph Otto's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Pediatric Radiology, with taxonomy code 2085P0229X.

Is Randolph Otto enrolled in Medicare?

Yes. Randolph 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 Randolph Otto accept?

Health plans from Premera Blue Cross Blue Shield of Alaska list Randolph 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.

When was this NPI record last updated?

The NPPES record for Randolph Otto was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.