Bradley Alan Otto (NPI# 1114969185, PAC ID# 6406802305) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OTOLARYNGOLOGY.
| Nation Provider ID (NPI) | 1114969185 |
| PAC ID by PECOS | 6406802305 |
| Professional Enrollment ID | I20050323001274 |
| Full Name | Bradley Alan Otto |
| Organization Legal Name | OSU OTOLARYNGOLOGY HEAD AND NECK SURGERY, LLC |
| Address |
5175 Morse Rd Gahanna OH 43230-1370 |
| Phone Number | 6143663687 |
| Gender | M |
| Credential | MD |
| Medical School | WRIGHT STATE UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 2002 |
| Primary Specialty | OTOLARYNGOLOGY |
| Group Practice PAC ID | 9830114529 |
| Number of Group Practice Members | 51 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 360085 | OHIO STATE UNIVERSITY STATE HEALTH SYSTEM |
| 360242 | JAMES CANCER HOSPITAL & SOLOVE RESEARCH INSTITUTE |
| Address | Phone | Organization |
|---|---|---|
| 5175 Morse Rd, Gahanna, OH 43230-1370 | 6143663687 | OSU OTOLARYNGOLOGY HEAD AND NECK SURGERY, LLC |
| Organization Legal Name | OSU OTOLARYNGOLOGY HEAD AND NECK SURGERY, LLC |
| Physicians | 53 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Alexander A. Farag | Otolaryngology | Osu Otolaryngology Head and Neck Surgery, LLC | 915 Olentangy River Rd, Columbus, OH 43212-3153 |
| Katherine Kyle Mead | Physician Assistant | Osu Otolaryngology Head and Neck Surgery, LLC | 460 W 10th Ave, Columbus, OH 43210-1240 |
| Kara Vasil | Qualified Audiologist | Osu Otolaryngology Head and Neck Surgery, LLC | 915 Olentangy River Rd, Columbus, OH 43212-3153 |
| Karen Sue Smith | Physician Assistant | Osu Otolaryngology Head and Neck Surgery, LLC | 460 W 10th Ave, Columbus, OH 43210-1240 |
| Amit Agrawal | Otolaryngology | Osu Otolaryngology Head and Neck Surgery, LLC | 460 W 10th Ave, Columbus, OH 43210-1240 |
| Aaron C Moberly | Otolaryngology | Osu Otolaryngology Head and Neck Surgery, LLC | 460 W 10th Ave, Columbus, OH 43210-1240 |
| Sara Jo Harbison | Nurse Practitioner | Osu Otolaryngology Head and Neck Surgery, LLC | 915 Olentangy River Rd, Columbus, OH 43212-3153 |
| Brenda B Hall | Qualified Audiologist | Osu Otolaryngology Head and Neck Surgery, LLC | 5175 Morse Rd, Gahanna, OH 43230-1370 |
| Gretchen L Waggoner | Qualified Audiologist | Osu Otolaryngology Head and Neck Surgery, LLC | 5175 Morse Rd, Gahanna, OH 43230-1370 |
| Carolyn T Mickelson | Qualified Audiologist | Osu Otolaryngology Head and Neck Surgery, LLC | 460 W 10th Ave, Columbus, OH 43210-1240 |
| Street Address |
5175 MORSE RD |
| City | GAHANNA |
| State | OH |
| Zip | 43230-1370 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Susan C Massick | Dermatology | Osu Internal Medicine, LLC | 5175 Morse Rd, Gahanna, OH 43230-1370 |
| Brenda B Hall | Qualified Audiologist | Osu Otolaryngology Head and Neck Surgery, LLC | 5175 Morse Rd, Gahanna, OH 43230-1370 |
| Gretchen L Waggoner | Qualified Audiologist | Osu Otolaryngology Head and Neck Surgery, LLC | 5175 Morse Rd, Gahanna, OH 43230-1370 |
| Brad W Desilva | Otolaryngology | Osu Otolaryngology Head and Neck Surgery, LLC | 5175 Morse Rd, Gahanna, OH 43230-1370 |
| Eugene G Chio | Otolaryngology | Osu Otolaryngology Head and Neck Surgery, LLC | 5175 Morse Rd, Gahanna, OH 43230-1370 |
| Charity C Fox | Allergy/immunology | Osu Otolaryngology Head and Neck Surgery, LLC | 5175 Morse Rd, Gahanna, OH 43230-1370 |
| Laura E Feeney | Qualified Audiologist | Osu Otolaryngology Head and Neck Surgery, LLC | 5175 Morse Rd, Gahanna, OH 43230-1370 |
| Nicole Hacker | Audiologist | Osu Otolaryngology Head and Neck Surgery, LLC | 5175 Morse Rd, Gahanna, OH 43230-1370 |
| Karen H Calhoun | Otolaryngology | Osu Otolaryngology Head and Neck Surgery, LLC | 5175 Morse Rd, Gahanna, OH 43230-1370 |
| Emily H Shindeldecker | Nurse Practitioner | Osu Otolaryngology Head and Neck Surgery, LLC | 5175 Morse Rd, Gahanna, OH 43230-1370 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Patricia A Bacon | Family Medicine | Drs. Bacon and Hooper, Inc. | 1045 Beecher Crossing N, Suite B, Gahanna, OH 43230 |
| Kimberly C Hooper | Family Medicine | Drs. Bacon and Hooper, Inc. | 1045 Beecher Crossing N, Suite B, Gahanna, OH 43230 |
| Christopher A Hess | Chiropractic | 830 E Johnsontown Rd, Gahanna, OH 43230-0001 | |
| Emily Evans | Physical Therapy | Ohrh, LLC | 5650 N Hamilton Rd, Columbus, OH 43230-1324 |
| Brian M Sammon | Family Practice | Ohiohealth Urgent Care LLC | 5610 N Hamilton Rd, Columbus, OH 43230-1324 |
| Gisele Johnson | Physical Therapy | Ohrh, LLC | 5650 N Hamilton Rd, Columbus, OH 43230-1324 |
| Patrick Joseph Dineen | Internal Medicine | 5691 Thompson Rd, Columbus, OH 43230-1345 | |
| Antoine Eskander | Otolaryngology | Osu Otolaryngology Head and Neck Surgery, LLC | 5175 Morse Rd, Gahanna, OH 43230-1370 |
| Megan Quimper | Obstetrics/gynecology | Osu Gyn and Ob Consultants, LLC | 920 N Hamilton Rd, Suite 200, Gahanna, OH 43230-1757 |
| Clinton A Hartz | Family Medicine | Osu Emergency Medicine LLC | 920 N Hamilton Rd, Suite 600, Gahanna, OH 43230-1757 |
| Find all physicians in zip 43230 | |||
| City | GAHANNA |
| Zip Code | 43230 |
| Specialty | OTOLARYNGOLOGY |
| City + Specialty | GAHANNA + OTOLARYNGOLOGY |
Please comment or provide details below to improve the information on Bradley Alan Otto.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.