Individual provider Active NPI

Odysseus Adamides Jr., M.D.

  • Forensic Psychiatry Physician
  • Lyons, NY
National Provider Identifier
1174786966
Registry record updated Jul 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Forensic Psychiatry PhysicianTaxonomy code 2084F0202X
License
132100 Issued in NY
Practice address
1519 Nye Rd
Lyons, NY 14489-9133
Phone
(315) 946-5722
NPI assigned
Jul 2, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Forensic Psychiatry Physician 2084F0202X 132100 NY Primary
Addiction Psychiatry Physician 2084P0802X 132100 NY

Addresses

Primary practice location

1519 Nye Rd
Lyons, NY 14489-9133

Mailing address

14 Park Forest Dr
Pittsford, NY 14534-3559
Phone (585) 383-5678

Other identifiers 1

IdentifierTypeStateIssuer
00357502MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040510000802 NY Practitioner - Psychiatry 7315936861 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Catholic Charities of the Diocese of RochesterGroup PAC ID 0345334272, 11 clinicians

Practice addresses (Care Compare)

79 N Clinton Ave
Rochester, NY 14604-1407
Phone (585) 546-7220

87 N Clinton Ave
Rochester, NY 14604-1407

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
132100NYMDForensic Psychiatry Physician

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.

NPI Registry JSON

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214956800000",
    "number": "1174786966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 PARK FOREST DR",
            "city": "PITTSFORD",
            "state": "NY",
            "postal_code": "145343559",
            "telephone_number": "585-383-5678",
            "fax_number": "585-248-0198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1519 NYE RD",
            "city": "LYONS",
            "state": "NY",
            "postal_code": "144899133",
            "telephone_number": "315-946-5722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMIDES",
        "first_name": "ODYSSEUS",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-02",
        "last_updated": "2008-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "NY",
            "license": "132100",
            "primary": true
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "NY",
            "license": "132100",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00357502",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lyons, NY

Sources for this page

Verify at the official NPI Registry.