Marlise Gnutzmann Botelho, PA
NPI 1285801647ActiveIndividual· Physician Assistant, Medical· Dayton, OH
Physician Assistant, Medical (PA) with Grand Traverse Physician Services PC, practicing in Dayton, Ohio. 153 Medicare patients in 2024, $20,004 paid; nearly all of their 136 Part D prescriptions were generic (92%). Lists Munson Medical Center as a hospital affiliation.
Overview
| NPI | 1285801647 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PA |
| Sole proprietor | No |
| NPI issued | May 14, 2008 |
| Last updated in NPPES | Jul 21, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant, Medical Primary | 363AM0700X | 2764 | OH |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (MI) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 153 |
|---|---|
| Services billed | 286 across 9 procedure codes |
| Paid by Medicare | $20,004 |
Part D prescriptions in 2024
| Prescriptions (claims) | 136 · 139 30-day fills |
|---|---|
| Patients | 84 |
| Total drug cost | $7,239 |
| Generic share | 92% of claims |
Education and affiliations
| Graduation year | 2007 |
|---|---|
| Medicare specialty | Physician Assistant |
Medical group
- Grand Traverse Physician Services PCTraverse City, MI · 113 clinicians
Hospital affiliation
- Munson Medical CenterTraverse City, MI
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
Other Physician Assistant, Medical providers in Dayton
- 1497787931
- 1184998262
- 1033944103
- 1790011724
- 1073651337
- 1922552454
- 1831429430
- 1851866206
- 1215041876
- 1487783080
- 1437235058
- 1194266270