Individual provider Active NPI

Joseph Alfred Odierno, DO

  • Emergency Medicine Physician
  • Annapolis, MD
National Provider Identifier
1396306858
Registry record updated Mar 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
H0093721 Issued in MD
Practice address
2001 Medical Pkwy
Annapolis, MD 21401-3773
Phone
(443) 481-1000
NPI assigned
Jun 25, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X H0093721 MD Primary

Addresses

Primary practice location

2001 Medical Pkwy
Annapolis, MD 21401-3773

Mailing address

2001 Medical Pkwy
Annapolis, MD 21401-3773

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220729000252 MD Practitioner - Emergency Medicine 1658608526 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
H0093721MDMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors Emergency Service, PA Emergency Medicine CurrentSince Aug 1, 2022 Accepting new patients

Locations

2001 Medical Pkwy
Annapolis, MD 21401
Phone (410) 280-5601

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": "1561420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1396306858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 MEDICAL PKWY",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 MEDICAL PKWY",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013773",
            "telephone_number": "443-481-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODIERNO",
        "first_name": "JOSEPH",
        "middle_name": "ALFRED",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-25",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "H0093721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.