Jeffrey Douglas O'Dell, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

01084702A Issued in IN

Practice address

1355 Mariners Dr
Warsaw, IN 46582-7145

Phone

(574) 267-6778

Fax

(574) 267-3134

NPI assigned

Jan 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 3

Medicare fee-for-service enrollment

Enrolled in IN

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

Merit-based Incentive Payment System (MIPS)

Final score

83.53 of 100Reported as group

Quality

70

Promoting interoperability

100

Improvement activities

40

Cost

75.11

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jodell455075@direct.parkviewexchange.com

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.

• Parkview Health System Inc

  • Family Medicine Physician
  • Fort Wayne, IN
  • NPI 1932130952

  Pediatrics

  Medicare reassignment NPD
• Northeast Obstetrics & Gynecology, LLC

  • Medical Specialty Clinic/Center
  • Fort Wayne, IN
  • NPI 1811941024
  NPD (past)

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1336129378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 MARINERS DR",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465827145",
            "telephone_number": "574-267-6778",
            "fax_number": "574-267-3134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DELL",
        "first_name": "JEFFREY",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101232521",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01084702A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1355 Mariners Drive",
            "city": "Warsaw",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46582",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "1355 Mariners Drive",
            "city": "Warsaw",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46582",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jodell455075@Direct.Parkviewexchange.com",
            "affiliation": "N",
            "address_1": "1355 Mariners Drive",
            "city": "Warsaw",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46582",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Luan Nhan Nguyen, MD
• Hope Niemier
• Emma Kathryn Nifong
• Northeast Indiana Urology, P.C.
• Maria Nunez, MSED
• Brian Gerrit Ockerse, M.D.
• Alyssa Ocran
• Emily Oden
• Victoria Ong-Murrell, APRN
• Joyce Elaine Oppy, COTA

• Pediatrics Physician in Warsaw, IN
• Providers in Warsaw, IN by specialty
• Pediatrics Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.