Individual provider Active NPI

Barbara Odac, MD

  • Student in an Organized Health Care Education/Training Program
  • Bridgeport, CT
National Provider Identifier
1053061663
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
82943 Issued in CT
Practice address
267 Grant St, Med Ed Podium 4
Bridgeport, CT 06610-2870
Phone
(203) 384-4442
NPI assigned
Mar 25, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 82943 CT Primary

Addresses

Primary practice location

267 Grant St, Med Ed Podium 4
Bridgeport, CT 06610-2870

Mailing address

267 Grant St
Bridgeport, CT 06610-2870

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251007002221 CT Practitioner - Internal MedicinePractitioner - Hospitalist 0042717035 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Griffin Faculty Physicians IncGroup PAC ID 7618871997, 125 clinicians

Practice addresses (Care Compare)

130 Division St
Derby, CT 06418-1326
Phone (203) 732-1352

Hospital & facility affiliations

  • Griffin Hospital Hospital, Derby, CT, CCN 070031

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Griffin Faculty Physicians, Inc. Internal Medicine CurrentSince Nov 1, 2025 Accepting new patients

Locations

67 Maple Ave
Derby, CT 06418
Phone (203) 732-0699

130 Division St
Derby, CT 06418
Phone (203) 732-1330

Interoperability endpoints

  • Direct secure messaging: barbara.odac.1@1323.direct.athenahealth.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1648166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1053061663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "267 GRANT ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066102870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "267 GRANT ST, MED ED PODIUM 4",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066102870",
            "telephone_number": "203-384-4442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODAC",
        "first_name": "BARBARA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-25",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CT",
            "license": "82943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.