KIMBERLYN J OTTO (LCSW) – Clinical Social Worker, NPI 1053465989

KIMBERLYN J OTTO (LCSW) is a healthcare provider. based in Evansville, Wisconsin. specializing in Clinical Social Worker. They hold the professional credentials LCSW. They hold a License No. 3013 (WI). The NPI Number for KIMBERLYN J OTTO (LCSW) is 1053465989

Main info

Female
35 Years Of Experience
Accepts Medicare Assignment
Name
KIMBERLYN J OTTO (LCSW)
NPI
1053465989
Phone
(608) 882-5613
Address
300 UNION ST
Enumeration Date
22 January 2007
Last Update Date
18 January 2011

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6088825613
Graduation Year
1991 (35 years ago)
PAC ID
0042409443
Group Practice PAC ID
7416860440
Professional Enrollment ID
I20110118000253
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for KIMBERLYN J OTTO (LCSW)

  • Mercyhealth Evansville, 300, Union Street, Evansville, Rock County, Wisconsin, 53536, United States

    EVANSVILLE, WI 535361175

    Phone: (608) 882-5613

    Mailing address matches the actual address.

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: 2011-01-18

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
I20110118000253IClinical Social WorkerWITBD

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
90834Psychotherapy, 45 minutes28942$0
View full utilization report →

Insurance plans in this area (ZIP 53536)

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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: 7416860440View full group profile
NameSpecialtyState
-WI
Nurse PractitionerWI
-WI
O P H T H A L M O L O G YIL
-WI
-IL
-WI
Hematology/Oncology, Internal MedicineIL
-WI
Family Practice, Geriatric MedicineIL

Reviews

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Frequently asked questions

Where can patients find KIMBERLYN J OTTO (LCSW)'s NPI?
You can confirm KIMBERLYN J OTTO (LCSW) with NPI 1053465989; it appears in the national provider directory.
Is KIMBERLYN J OTTO (LCSW) currently active in the NPI registry?
CMS-published data lists KIMBERLYN J OTTO (LCSW) as an active registrant.
Can you summarize KIMBERLYN J OTTO (LCSW)'s specialty in plain language?
Clinically, the directory lists KIMBERLYN J OTTO (LCSW) with Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What location metadata exists for KIMBERLYN J OTTO (LCSW)?
The page summarizes Evansville, Wisconsin for KIMBERLYN J OTTO (LCSW); expand the address list for detail.
Is KIMBERLYN J OTTO (LCSW) a real provider?
This page reflects official NPPES data for NPI 1053465989. Always confirm identity and privileges with the practice and licensing boards.

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