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

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Otis Perry Max Ingersoll, FNP is a medicare enrolled "Nurse Practitioner - Family" in Albany, California. 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 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 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 NameOtis Perry Max Ingersoll
GenderMale
SpecialityNurse Practitioner - Family
Location500 San Pablo Ave, Albany, California
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  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.
IdentifierTypeStateIssuer
1386838407NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 14774 (California)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. Otis Perry Max Ingersoll allows following entities to bill medicare on his behalf.
Entity NameCep America - California
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1023063542
PECOS PAC ID: 6103739131
Enrollment ID: O20031106000520
Entity NameSutter Bay Medical Foundation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI 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 AddressPractice 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: Not Enrolled in Medicare
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: Medicare Enrolled
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    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.