Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Andrew T Otto, PA-C

Individual provider Surgical Physician Assistant · NPI 1093726648

Andrew T Otto, PA-C is a Physician Assistant in Greenville, South Carolina. Graduated from Southern Illinois University School of Medicine in 2001, 25 years ago. Practices with Self Medical Group, a 396-clinician group and accepts Medicare assignment. Licensed in South Carolina.

Years since qualifying
25
Trained at
Southern Illinois University School of Medicine
Licensed in
SC
In the registry since
2006
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

200 Patewood Dr Ste C100
Greenville, SC 29615-6322
Phone: (864) 454-7422
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 843 (SC)

Record details

NPI number1093726648
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 10, 2006
Last updated in NPPESApril 20, 2017

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolSOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE
Graduated 2001 (25 years in practice)
Group practice Self Medical Group — 396 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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