Dr Justin A Otis, DNP, APRN-CRNA in Jacksonville, FL - Medicare Nurse Anesthetist, Certified Registered

Dr Justin A Otis, DNP, APRN-CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Jacksonville, Florida. His current practice location is 11723 Wells Creek Pkwy Apt 1217, Jacksonville, Florida. You can reach out to his office (for appointments etc.) via phone at (904) 240-2841.

Dr Justin A Otis is licensed to practice in Kentucky (license number 4012118) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1245911262.

Contact Information

	Dr Justin A Otis, DNP, APRN-CRNA
	11723 Wells Creek Pkwy Apt 1217, Jacksonville, FL 32256-1981
	(904) 240-2841
	Not Available

Map and Direction

Provider's Profile

Full Name	Dr Justin A Otis
Gender	Male
Speciality	Nurse Anesthetist, Certified Registered
Location	11723 Wells Creek Pkwy Apt 1217, Jacksonville, Florida
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1245911262
Provider Enumeration Date: 07/31/2023
Last Update Date: 01/25/2024

Medicare PECOS Information:

PECOS PAC ID: 5496192254
Enrollment ID: I20240328001753

Medical Identifiers

Medical identifiers for Dr Justin A Otis such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1245911262	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163W00000X	Registered Nurse	RN9356204 (Florida)	Secondary
367500000X	Nurse Anesthetist, Certified Registered	4012118 (Kentucky)	Primary

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. Dr Justin A Otis allows following entities to bill medicare on his behalf.

Entity Name	Greater Louisville Anesthesia Services, Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1326126681 PECOS PAC ID: 2264410661 Enrollment ID: O20040712001150

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. Dr Justin A Otis 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
Dr Justin A Otis, DNP, APRN-CRNA 2115 Judge Carden Blvd, Crestwood, KY 40014-7805 Ph: (904) 240-2841	Dr Justin A Otis, DNP, APRN-CRNA 11723 Wells Creek Pkwy Apt 1217, Jacksonville, FL 32256-1981 Ph: (904) 240-2841

Reviews and Comments

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Dr Justin A Otis, DNP, APRN-CRNA - Medicare Nurse Anesthetist, Certified Registered in Jacksonville, FL