John Odenwald

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

520 W Fayette St Ste 300
Baltimore, MD 21201-1756

Phone

(410) 693-5241

NPI assigned

Sep 25, 2023

Sex

Male

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 MD

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

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Maryland General Clinical Practice Group, Inc.Group PAC ID 8123926649, 61 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of MD Medical Center Midtown Campus Hospital, Baltimore, MD, CCN 210038

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jodenwald1021025@direct.umm.edu

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.

• Maryland General Clinical Practice Group, Inc.

  • Multi-Specialty Clinic/Center
  • Baltimore, MD
  • NPI 1770684805
  Medicare reassignment Care Compare group
• Maryland General Clinical Practice Group, Inc.

  • Psychiatry Physician
  • Baltimore, MD
  • NPI 1689413197
  NPD

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

• Maryland General Hospital Inc

  dba University of Maryland Medical Center Midtown Campus

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1669565180
  Care Compare affiliation

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

{
    "created_epoch": "1695600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1265211825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 W FAYETTE ST STE 300",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 W FAYETTE ST STE 300",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011756",
            "telephone_number": "410-693-5241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODENWALD",
        "first_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-25",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nour Basem Kamel Odeh, MBBS
• Andrea Odell, LCSW-C
• Kathleen Suzanne Odell, CRNP-FAMILY
• Stephanie Odenigbo
• Patience Ifeyinka Odeniyide, MD
• Maricia Odeyemi
• Joan Odiaka
• Edith Odiana, RN
• Dennis Odie, M.D.
• Mariontino Odighizuwa, PA-C

• Physician Assistant in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; 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.