Individual provider Active NPI

Brennen O'Dell, DPM

  • Podiatrist
  • Ann Arbor, MI
National Provider Identifier
1356831408
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
5901400400 Issued in MI
Practice address
24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105-9484
Phone
(734) 647-5871
NPI assigned
May 15, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 5901400400 MI
Podiatrist 213E00000X 5901400400 MI Primary

Addresses

Primary practice location

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105-9484

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

Other practice location 1

University of Michigan/MEND
24 Frank Lloyd Wright Dr. Lobby C
Ann Arbor, MI 48105
Phone (342) 322-2527

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230824000785 MI Practitioner - Podiatry 6103228564 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
College of Podiatric Med and Surgery, Des Moines University, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Regents of the University of MichiganGroup PAC ID 3779496856, shared by 45 NPIs, 3,344 clinicians

Practice addresses (Care Compare)

1500 E Medical Ctr Dr
Ann Arbor, MI 48109-5000

2098 S Main St
Ann Arbor, MI 48103-5827
Phone (734) 936-5780

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105-9484
Phone (734) 936-5780

24 Frank Lloyd Wright Dr Lobby C
Umhs Domino'S Farms
Ann Arbor, MI 48105-9484
Phone (734) 647-5871

Hospital & facility affiliations

  • University of Michigan Health System Hospital, Ann Arbor, MI, CCN 230046

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue176
Removal of nail tissue36
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan CurrentSince Jul 11, 2023 Accepting new patients
Regents of the University of Michigan CurrentSince May 28, 2024 Accepting new patients
Regents of the University of Michigan Podiatrist CurrentSince Jul 11, 2023 Accepting new patients
Regents of the University of Michigan Past Accepting new patients

Locations

380 Parkland Plz
Ann Arbor, MI 48103
Phone (734) 615-3217

2098 S Main St
Ann Arbor, MI 48103
Phone (734) 936-5780

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

325 E Eisenhower Pkwy
Ann Arbor, MI 48108
Phone (734) 615-7246

7500 Challis Rd
Brighton, MI 48116
Phone (734) 764-4190

1051 N Canton Center Rd
Canton, MI 48187
Phone (734) 647-5670

39901 Traditions Dr
Fl 1
Northville, MI 48168

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1526342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1356831408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059484",
            "telephone_number": "734-647-5871"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "University of Michigan/MEND",
            "address_2": "24 Frank Lloyd Wright Dr. Lobby C",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "48105",
            "country_code": "US",
            "telephone_number": "342-322-2527",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'DELL",
        "first_name": "BRENNEN",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-15",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": "5901400400",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "5901400400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.