Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mark Risen Otstot

Individual provider Physician Assistant · NPI 1225998271

Mark Risen Otstot is a Physician Assistant in Roanoke, Virginia. Qualified in 2025, 1 year ago. Licensed in Virginia.

Years since qualifying
1
Licensed in
VA
In the registry since
2025
Specialties on file
2

Practice location Address checks out

1906 Belleview Ave SE
Roanoke, VA 24014-1838
Phone: (540) 981-7000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0110011626 (VA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1225998271
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedNovember 13, 2025
Last updated in NPPESMarch 25, 2026
Certification dateMarch 25, 2026
Mailing address213 S Jefferson St Ste 1006, Roanoke, VA 24011-1713

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated

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