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

Michael Otto, PA-C

Individual provider Surgical Physician Assistant · NPI 1639168891

Michael Otto, PA-C is a Physician Assistant in Lima, Ohio. Qualified in 2008, 18 years ago. Practices with Lima Memorial Professional Corporation, a 169-clinician group and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
18
Licensed in
OH
In the registry since
2005
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

730 W Market St Ste 2K
Lima, OH 45801-4602
Phone: (419) 996-4011
Fax: (419) 996-4012
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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 50001888 (OH)

Record details

NPI number1639168891
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 19, 2005
Last updated in NPPESNovember 5, 2020
Certification dateNovember 5, 2020
Mailing address730 W Market St Ste 2k, Lima, OH 45801-4602

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Lima Memorial Professional Corporation — 169 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

Other providers in Lima