Moromoke O Odina, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

0101251411 Issued in VA

Practice address

11050 Mount Belvedere Blvd
Fort Drum, NY 13602-5438

Phone

(315) 772-2778

NPI assigned

Sep 30, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Internal Medicine

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pine Medical PLLCGroup PAC ID 1850639709, 6 clinicians

Health and Human Services CommissionGroup PAC ID 2163795824, 138 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Oakbend Medical Center Hospital, Richmond, TX, CCN 450330
• University of Texas Medical Branch Galveston Hospital, Galveston, TX, CCN 450018
• Ad Hospital East, LLC Hospital, Houston, TX, CCN 670102

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Pine Medical PLLC

  dba Bellville Urgent Care Clinic

  • Urgent Care Clinic/Center
  • Bellville, TX
  • NPI 1598232035
  Medicare reassignment Care Compare group Authorized official
• Health and Human Services Commission

  dba Rio Grande State Center

  • Clinical Neuropsychologist
  • Harlingen, TX
  • NPI 1356414692
  Medicare reassignment Care Compare group
• Health and Human Services Commission

  • Intellectual Disabilities Intermediate Care Facility
  • Richmond, TX
  • NPI 1790851202

  Internal Medicine

  NPD

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

• Ad Hospital East, LLC

  • General Acute Care Hospital
  • Houston, TX
  • NPI 1669732178
  Care Compare affiliation
• Oakbend Medical Center

  • General Acute Care Hospital
  • Richmond, TX
  • NPI 1700883196
  Care Compare affiliation
• University of Texas Medical Branch at Galveston

  dba University of Texas Medical Branch

  • General Acute Care Hospital
  • Galveston, TX
  • NPI 1548226988
  Care Compare affiliation

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

{
    "created_epoch": "1285804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381968000000",
    "number": "1225347735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11050 MOUNT BELVEDERE BLVD",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "136025438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11050 MOUNT BELVEDERE BLVD",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "136025438",
            "telephone_number": "315-772-2778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODINA",
        "first_name": "MOROMOKE",
        "middle_name": "O",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-30",
        "last_updated": "2013-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101251411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bethany Lyn Northrop, LCSW
• Marcia Ann Norton, LPC
• Christopher Nuckols, DMD
• Victoria Jeanne O'Brien, DO
• Alexandra O'Donnell, VMD, MS
• Patrick Murphy Ogden, PA-C
• Jesse Alexander Ojeda
• Ashante Monique Osei Asibey, ATC
• Catherine Padron, L.C.S.W.
• Richard Padron, DDS

• Internal Medicine Physician in Fort Drum, NY
• Providers in Fort Drum, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.