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

Mary Otteman, PA

Individual provider Physician Assistant · NPI 1821541905

Mary Otteman, PA is a Physician Assistant in Omaha, Nebraska. Qualified in 2016, 10 years ago. Practices with Mod Dermatology PC, a 7-clinician group and accepts Medicare assignment. Licensed in Nebraska.

Years since qualifying
10
Licensed in
NE
In the registry since
2016
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

16910 Frances St
Omaha, NE 68130-2398
Phone: (402) 505-8777
Fax: (402) 933-7767
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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 2023 (NE)

Record details

NPI number1821541905
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJuly 26, 2016
Last updated in NPPESJuly 6, 2022
Certification dateJuly 6, 2022
Mailing address16910 Frances St, Omaha, NE 68130-2398

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Mod Dermatology Pc — 7 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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