KELLEE OTT – Obstetrics & Gynecology Physician, NPI 1154308153

KELLEE OTT is a healthcare provider. based in St louis park, Minnesota. specializing in OBSTETRICS/GYNECOLOGY. They hold a License No. 45596 (MN). The NPI Number for KELLEE OTT is 1154308153

Main info

Female
27 Years Of Experience
Accepts Medicare Assignment
Name
KELLEE OTT
NPI
1154308153
Phone
Not provided
Address
3800 PARK NICOLLET BLVD
Enumeration Date
30 December 2005
Last Update Date
9 March 2021

Doctor Profile

Medical School Name
UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Secondary Phone
9529932400
Graduation Year
1999 (27 years ago)
PAC ID
4981749991
Group Practice PAC ID
7911819438
Professional Enrollment ID
I20100302000571
Address ID
MN554373934BL5320XDRXX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

822 OBSTETRICS/GYNECOLOGY in MN

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Provider Addresses for KELLEE OTT

  • 3800, Park Nicollet Boulevard, Elmwood, Saint Louis Park, Hennepin County, Minnesota, 55416, United States

    CREDENTIALING

    ST LOUIS PARK, MN 554162527

    Phone:

    Type: Mailing

  • 8170 33RD AVE S # MS 21110Q

    BLOOMINGTON, MN 554254516

    Phone:

    Type: Mailing

  • Hyland Greens Drive, Bloomington, Hennepin County, Minnesota, 55437, United States

    BLOOMINGTON, MN 554373934

    Phone: (952) 993-2460

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2010-03-02

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100302000571IObstetrics/GynecologyMNTBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes1312$0
View full utilization report →

Insurance plans in this area (ZIP 55416)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7911819438View full group profile
NameSpecialtyState
O B S T E T R I C S/ G Y N E C O L O G YMN
Family PracticeMN
-MN
Pulmonary Disease, Critical Care (Intensivists), Internal MedicineMN
Cardiac ElectrophysiologyMN
Family PracticeMN
Physician AssistantMN
Physical Therapist In Private PracticeMN
Physician AssistantMN
D E R M A T O L O G YMN

Reviews

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Frequently asked questions

What is the standard ID for KELLEE OTT in the U.S.?
In the U.S., KELLEE OTT is identified by NPI 1154308153.
Is KELLEE OTT's NPI status active today?
Active status means KELLEE OTT's NPI record is not deactivated in the public file.
What services align with KELLEE OTT's listing?
KELLEE OTT's public classification highlights Obstetrics & Gynecology Physician. Clinical services aligned with this taxonomy classification.
Which community is linked to KELLEE OTT?
KELLEE OTT shows a connection to St Louis Park, Minnesota in registry-derived data.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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