Otis Perry Max Ingersoll, FNP in Albany, CA - Medicare Nurse Practitioner

Otis Perry Max Ingersoll, FNP is a medicare enrolled "Nurse Practitioner - Family" in Albany, California. He graduated from nursing school in 2003 and has 21 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice Sutter Bay Medical Foundation and his current practice location is 500 San Pablo Ave, Albany, California. You can reach out to his office (for appointments etc.) via phone at (510) 204-8130.

Otis Perry Max Ingersoll is licensed to practice in California (license number 14774) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1386838407.

Contact Information

	Otis Perry Max Ingersoll, FNP
	500 San Pablo Ave, Albany, CA 94706-1103
	(510) 204-8130
	(510) 524-0861

Map and Direction

Provider's Profile

Full Name	Otis Perry Max Ingersoll
Gender	Male
Speciality	Nurse Practitioner
Experience	21 Years
Location	500 San Pablo Ave, Albany, California
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Otis Perry Max Ingersoll graduated from nursing school in 2003

NPI Data:

NPI Number: 1386838407
Provider Enumeration Date: 08/31/2007
Last Update Date: 02/10/2021

Medicare PECOS Information:

PECOS PAC ID: 0446431407
Enrollment ID: I20110223000875

Medical Identifiers

Medical identifiers for Otis Perry Max Ingersoll such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1386838407	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	14774 (California)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Alta Bates Summit Medical Center	Oakland, CA	Hospital
Alta Bates Summit Medical Center - Alta Bates Camp	Berkeley, CA	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Sutter Bay Medical Foundation	4284538778	2941

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Otis Perry Max Ingersoll allows following entities to bill medicare on his behalf.

Entity Name	Cep America - California
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1023063542 PECOS PAC ID: 6103739131 Enrollment ID: O20031106000520

Entity Name	Sutter Bay Medical Foundation
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1013950807 PECOS PAC ID: 4284538778 Enrollment ID: O20031125000909

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Otis Perry Max Ingersoll is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Otis Perry Max Ingersoll, FNP 500 San Pablo Ave, Albany, CA 94706-1103 Ph: (510) 204-8130	Otis Perry Max Ingersoll, FNP 500 San Pablo Ave, Albany, CA 94706-1103 Ph: (510) 204-8130

Reviews and Comments

Nurse Practitioner Nurses in Albany, CA

Mary Bunzel, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 500 San Pablo Ave, Albany, CA 94706 Phone: 510-204-8130 Fax: 510-524-0861
Margaret Kirkham, RN, MSN, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 500 San Pablo Ave, Albany, CA 94706 Phone: 510-204-8130
Michelle Frijas, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 405 Kains Ave Ste 201, Albany, CA 94706 Phone: 510-853-6116
Mary E. Wardlaw, N.P. Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 500 San Pablo Ave, Albany, CA 94706 Phone: 510-204-8130 Fax: 510-524-0861
Mr. Dewayne Lee Cecil, AGACNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1080 Monroe Ave, Suite 120, Albany, CA 94706 Phone: 510-439-9496
Mr. Drew Ho, NP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 500 San Pablo Ave, Suite 300, Albany, CA 94706 Phone: 510-204-8130

Otis Perry Max Ingersoll, FNP - Medicare Nurse Practitioner in Albany, CA