Odam Medical Group
A Medicare group practice based in Foley, MN: 3 NPIs enrolled under one PECOS associate control ID (PAC ID 4082911938), with 9 clinicians.
Medicare enrollment
Medicare enrollment files- PAC ID
- 4082911938
- Provider type
- Part B Supplier - Clinic/Group Practice
- Enrolled in
- MN
- Enrollments
- 1
- Group size
- 3 clinicians
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Practice locations
- 3
Enrollment records 1
| Enrollment ID | State | Provider type | NPI |
|---|---|---|---|
| O20160321002318 | MN | Part B Supplier - Clinic/Group Practice | 1578934683 |
NPIs in this group 3
NPPES NPI RegistryThese NPI records belong to the same enrolled organization. Each has its own page.
-
Odam Medical Group
- Clinic/Center
- Crystal, MN
- NPI 1578934683
-
Odam Medical Group
- Primary Care Clinic/Center
- Foley, MN
- NPI 1538059779
-
Odam Medical Group
- Primary Care Clinic/Center
- Saint Cloud, MN
- NPI 1902392525
Practice locations
- Saint Cloud, MN1
- Crystal, MN1
- Foley, MN1
Clinicians 9
Clinicians who reassign their Medicare benefits to this group (9) or whom Care Compare lists as members (3).
-
Julitta Adu-Gyamfi
- Family Nurse Practitioner
- Crystal, MN
- NPI 1356119523
-
Selase Adzo Agudu-Morgan, FNP-C
- Family Nurse Practitioner
- Farmington, MN
- NPI 1891278693
-
Samuel Yaw Boadu, DNP
- Nurse Practitioner
- Saint Paul, MN
- NPI 1063517100
-
Muna Saeed Farah
- Family Nurse Practitioner
- Saint Paul, MN
- NPI 1780247015
-
Nabeela Khan, PA-C
- Physician Assistant
- Crystal, MN
- NPI 1801510789
-
Robert Larbi-Odam, MD
- Family Medicine Physician
- Crystal, MN
- NPI 1457311409
-
Salma Mohamud
- Family Nurse Practitioner
- Saint Cloud, MN
- NPI 1891686507
-
Comfort Lumyedang Nchanji, MD
- Family Medicine Physician
- Crystal, MN
- NPI 1609493147
-
Kristofer Michael Wallman, MPAS, PA-C
- Medical Physician Assistant
- Foley, MN
- NPI 1962439547
Sources for this page
- Medicare Fee-For-Service Public Provider Enrollment: the enrollments, PAC ID, practice locations and benefit reassignments.
- Care Compare Doctors and Clinicians: group membership, group size and the name CMS shows patients.
- NPPES NPI Registry: the names and addresses of the NPIs above.