ICHIRO OTSU (MD) – Anesthesiology Physician, NPI 1053422378
Anesthesiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,514 ANESTHESIOLOGY in WA
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Provider Addresses for ICHIRO OTSU (MD)
PO BOX 84571
SEATTLE, WA 981245871
Phone: (425) 353-3788
Fax: (425) 353-8041
Type: Mailing
Valley Medical Center, 400, South 43rd Street, Renton, King County, Washington, 98055, United States
RENTON, WA 980555714
Phone: (425) 353-3788
Fax: (425) 353-8041
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 $15.
Total Amount is formed as General ($15) + Research ($0) + Ownership ($0) = $15.
Last reported payment date: 2024-10-18 • Largest payer in this snapshot: Merck Sharp & Dohme LLC ($15).
Total Amount
$15
General + Research + Ownership
Payments
1
Total payment records
General Amount
$15
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Merck Sharp & Dohme LLC | $15 |
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: 2011-02-17
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 |
|---|---|---|---|---|
| I20110217000349 | I | Anesthesiology | WA | 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 |
|---|---|---|---|---|
| 00811 | Anesthesia for other procedure on large bowel using an endoscope | 23 | 23 | $0 |
| 00731 | Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope | 18 | 18 | $0 |
| 00812 | Anesthesia for exam of colon using an endoscope | 16 | 16 | $0 |
Insurance plans in this area (ZIP 98124)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| ANESTHESIOLOGY | WA | 00142 | Anesthesia for lens surgery | 46 | 45 |
| ANESTHESIOLOGY | WA | 00790 | Anesthesia for procedure in upper abdomen including use of an endoscope | 13 | 13 |
| ANESTHESIOLOGY | WA | 76942 | Ultrasonic guidance imaging supervision and interpretation for insertion of needle | 16 | 14 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | WA | |
| Certified Registered Nurse Anesthetist (Crna) | WA | |
| Certified Registered Nurse Anesthetist (Crna) | NC | |
| Certified Registered Nurse Anesthetist (Crna) | TX | |
| Anesthesiology, Pain Management, Interventional Pain Management | WA | |
| A N E S T H E S I O L O G Y | WA | |
| A N E S T H E S I O L O G Y | WA | |
| A N E S T H E S I O L O G Y | PA | |
| - | WA | |
| A N E S T H E S I O L O G Y | DC |
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