Individual provider Active NPI

Sarah L Oddo, PA

  • Physician Assistant
  • Pulaski, NY
National Provider Identifier
1063715068
Registry record updated Aug 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
014359 Issued in NY
Practice address
61 Delano St
Pulaski, NY 13142-1400
Phone
(315) 342-0880
NPI assigned
Dec 13, 2010
Last updated
Aug 8, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 014359 NY Primary

Addresses

Primary practice location

61 Delano St
Pulaski, NY 13142-1400

Mailing address

61 Delano St
Pulaski, NY 13142-1400
Phone (315) 342-0880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110513000003 NY Practitioner - Physician Assistant 6901082668 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
014359NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Oswego County Health Services, Inc. CurrentSince Jul 1, 2013 Accepting new patients
Wee Care Pediatrics, PLLC Past Accepting new patients
Ted J. Triana, DO PC Past Accepting new patients

Locations

61 Delano St
Pulaski, NY 13142
Phone (315) 298-4274

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1292198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407456000000",
    "number": "1063715068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 DELANO ST",
            "city": "PULASKI",
            "state": "NY",
            "postal_code": "131421400",
            "telephone_number": "315-342-0880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 DELANO ST",
            "city": "PULASKI",
            "state": "NY",
            "postal_code": "131421400",
            "telephone_number": "315-342-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODDO",
        "first_name": "SARAH",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-13",
        "last_updated": "2014-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "014359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pulaski, NY

Sources for this page

Verify at the official NPI Registry.