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

Individual provider Surgical Physician Assistant · NPI 1881995447

Elizabeth R Otten, PA-C is a Physician Assistant in Grand Rapids, Michigan. Qualified in 2010, 16 years ago. Practices with Advanced Radiology Services PC, a 252-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
16
Licensed in
MI
In the registry since
2010
Specialties on file
2
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

3264 N Evergreen Dr NE
Grand Rapids, MI 49525-9746
Phone: (616) 363-7272
Fax: (616) 361-5828
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5601005945 (MI)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 5601005945 (MI)

Record details

NPI number1881995447
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedNovember 12, 2010
Last updated in NPPESJune 2, 2023
Certification dateJune 2, 2023

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Advanced Radiology Services Pc — 252 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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