DR. VICTORIA ANN OTHERSEN (D.O.) – Family Medicine Physician, NPI 1629075429
Family Medicine Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
2,861 FAMILY PRACTICE in IN
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Provider Addresses for DR. VICTORIA ANN OTHERSEN (D.O.)
Churchman Avenue, Beech Grove, Marion, Indiana, 46203, United States
BEECH GROVE, IN 46107
Phone: (317) 786-9285
Fax: (317) 781-2793
Type: Location
PO BOX 781076
DETROIT, MI 482781076
Phone: (317) 528-4800
Fax: (317) 865-1479
Type: Mailing
362 MERIDIAN PARKE LN STE A
GREENWOOD, IN 461429425
Phone: (317) 528-8760
Fax: (317) 528-8761
Type: Location
2030, Churchman Avenue, Indianapolis, Marion, Indiana, 46107, United States
BEECH GROVE, IN 461071044
Phone: (317) 786-9285
Fax: (317) 781-2793
Type: Mailing
2030 Churchman Ave # A
Beech Grove, IN 461071044
Phone: (317) 786-9285
Fax: (317) 781-2793
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $21.
Total Amount is formed as General ($21) + Research ($0) + Ownership ($0) = $21.
Last reported payment date: 2023-03-10 • Largest payer in this snapshot: Dexcom, Inc. ($21).
Total Amount
$21
General + Research + Ownership
Payments
1
Total payment records
General Amount
$21
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-03-10
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Dexcom, Inc. | $21 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-09-20
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040920001081 | I | Family Practice | IN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 534 | 293 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 187 | 187 | $0 |
| G0008 | Administration of influenza virus vaccine | 89 | 87 | $0 |
| 90682 | Influenza vaccine, quadrivalent derived from recombinant dna | 44 | 42 | $0 |
| 90662 | Influenza vaccine split virus, preservative free | 42 | 42 | $0 |
Insurance plans in this area (ZIP 46107)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IN | |
| - | IN | |
| - | IN | |
| - | MI | |
| - | IN | |
| - | IN | |
| Family Practice | IN | |
| - | MI | |
| Internal Medicine | IN | |
| Internal Medicine, Emergency Medicine | MI |
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