Tara M Otto (NPI# 1356509038, PAC ID# 8224289608) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DIAGNOSTIC RADIOLOGY.
| Nation Provider ID (NPI) | 1356509038 |
| PAC ID by PECOS | 8224289608 |
| Professional Enrollment ID | I20121112000538 |
| Full Name | Tara M Otto |
| Organization Legal Name | RADIOLOGY ASSOCIATES OF SOUTHWEST LOUISIANA |
| Address |
220 Fliva Ave Nw Fort Walton Beach FL 32548-4257 |
| Phone Number | 3374394706 |
| Gender | F |
| Medical School | UNIVERSITY OF SOUTH ALABAMA COLLEGE OF MEDICINE |
| Graduation Year | 2007 |
| Primary Specialty | DIAGNOSTIC RADIOLOGY |
| Group Practice PAC ID | 0941243562 |
| Number of Group Practice Members | 70 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110064 | MIDTOWN MEDICAL CENTER |
| 030002 | BANNER - UNIVERSITY MEDICAL CENTER PHOENIX |
| 670047 | THE HOSPITALS OF PROVIDENCE - EAST CAMPUS |
| 450587 | BROWNWOOD REGIONAL MEDICAL CENTER |
| 340131 | CAROLINA EAST MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 220 Fliva Ave Nw, Fort Walton Beach, FL 32548-4257 | 3374394706 | RADIOLOGY ASSOCIATES OF SOUTHWEST LOUISIANA |
| 220 Fliva Ave Nw, Fort Walton Beach, FL 32548-4257 | 2818704592 | IMAGING ASSOCIATES OF INDIANA PC |
| 220 Fliva Ave Nw, Fort Walton Beach, FL 32548-4257 | 8132532721 | RADIOLOGY ASSOCIATES OF TAMPA PA |
| 220 Fliva Ave Nw, Fort Walton Beach, FL 32548-4257 | 7027598600 | ELLIS BANDT BIRKIN KOLLINS AND WONG PLLC |
| 220 Fliva Ave Nw, Fort Walton Beach, FL 32548-4257 | 7134613573 | GEORGIA RADIOLOGY IMAGING CONSULTANTS LLC |
| 220 Fliva Ave Nw, Fort Walton Beach, FL 32548-4257 | 4242908004 | COASTAL RADIOLOGY ASSOCIATES PLLC |
| 506 Dory Ave, Fort Walton Beach, FL 32548-6900 | 6025216252 | SOUTHWEST DIAGNOSTIC IMAGING LTD |
| 6720 Bertner Ave, Houston, TX 77030-2604 | 8323554092 | SINGLETON ASSOCIATES PA |
| 10583 Ne 104th Cir, Oxford, FL 34484-3907 | 28187045922120 | SINGLETON ASSOCIATES PA |
| 1 Tampa General Cir, Tampa, FL 33606-3571 | 8132515822 | RADIOLOGY ASSOCIATES OF TAMPA PA |
| Organization Legal Name | RADIOLOGY ASSOCIATES OF SOUTHWEST LOUISIANA |
| Physicians | 49 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lisa Katherine Harris | Diagnostic Radiology | Radiology Associates of Southwest Louisiana | 16116 Wakeley St, Omaha, NE 68118-4004 |
| Jeremie Karsenti | Diagnostic Radiology | Radiology Associates of Southwest Louisiana | 3050 Ne 164th St, Miami, FL 33160-4131 |
| Benjamin S Boyle | Diagnostic Radiology | Radiology Associates of Southwest Louisiana | 1495 Gause Blvd, Slidell, LA 70458-2205 |
| Russ Marc Savit | Diagnostic Radiology | Radiology Associates of Southwest Louisiana | 130 Kahoma Village Loop, Lahaina, HI 96761-2763 |
| Renee W Bonetti | Diagnostic Radiology | Radiology Associates of Southwest Louisiana | 8000 Madison Blvd, Madison, AL 35758-2031 |
| Barbara A Newman | Diagnostic Radiology | Radiology Associates of Southwest Louisiana | 11650 Horizon Rd, Parkland, FL 33076-2661 |
| Peter Holt | Diagnostic Radiology | Radiology Associates of Southwest Louisiana | 1200 Queen Emma St, Apt 1511, Honolulu, HI 96813-6308 |
| Paul C Larson | Diagnostic Radiology | Radiology Associates of Southwest Louisiana | 1800 Ryan St, Suite 105, Lake Charles, LA 70601-6078 |
| Nathaniel G Hagler | Diagnostic Radiology | Radiology Associates of Southwest Louisiana | 11094 Commanders Ln, White Plains, MD 20695-3147 |
| Danit Talmi | Diagnostic Radiology | Radiology Associates of Southwest Louisiana | 8596 E 35th Ave, Denver, CO 80238-3418 |
| Street Address |
220 FLIVA AVE NW |
| City | FORT WALTON BEACH |
| State | FL |
| Zip | 32548-4257 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Christopher S Lawton | Diagnostic Radiology | Radiology Regional Center Professional Services LLC | 220 Fliva Ave Nw, Fort Walton Beach, FL 32548-4257 |
| Brett K Searcey | Diagnostic Radiology | Radiology Regional Center Professional Services LLC | 220 Fliva Ave Nw, Fort Walton Beach, FL 32548-4257 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Crystal A Bonanni | Physician Assistant | All Seasons Allergy and Asthma Center, P.a. | 362 Beal Pkwy Nw, Suite 105, Fort Walton Beach, FL 32548-3926 |
| Justin P Clark | Allergy/immunology | All Seasons Allergy and Asthma Center, P.a. | 362 Beal Pkwy Nw, Suite 105, Fort Walton Beach, FL 32548-3926 |
| Narendra K Gowda | Internal Medicine | 514 Mary Esther Cutoff Nw, Fort Walton Beach, FL 32548-4025 | |
| Kaitlin J Weeks | Physician Assistant | Quality Urgent Care and Wellness Pl | 514 Mary Esther Cut Off Nw, Fort Walton Beach, FL 32548-4047 |
| Kena M Troupe | Nurse Practitioner | Quality Urgent Care and Wellness Pl | 514 Mary Esther Cut Off Nw, Fort Walton Beach, FL 32548-4047 |
| Stephanie Hengle | Nurse Practitioner | Quality Urgent Care and Wellness Pl | 514 Mary Esther Cut Off Nw, Fort Walton Beach, FL 32548-4047 |
| Brittany P Brock | Physician Assistant | Quality Urgent Care and Wellness Pl | 514 Mary Esther Cut Off Nw, Fort Walton Beach, FL 32548-4047 |
| Judy S Cavazos | Physician Assistant | Quality Urgent Care and Wellness Pl | 514 Mary Esther Cut Off Nw, Fort Walton Beach, FL 32548-4047 |
| Jasmine Ts Pang | Family Practice | Quality Urgent Care and Wellness Pl | 514 Mary Esther Cut Off Nw, Fort Walton Beach, FL 32548-4047 |
| Robert P Mann | Physical Therapy | White Sands Physical Therapy Inc | 600 Opp Dr, Fort Walton Beach, FL 32548-4284 |
| Find all physicians in zip 32548 | |||
| City | FORT WALTON BEACH |
| Zip Code | 32548 |
| Specialty | DIAGNOSTIC RADIOLOGY |
| City + Specialty | FORT WALTON BEACH + DIAGNOSTIC RADIOLOGY |
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| 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.