Active NPI
Patrick J O'Dea, MD
- Gastroenterology Physician
- Newburyport, MA
National Provider Identifier
1427051366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 01023960A
- Practice address
- 11 Titcomb St
Newburyport, MA 01950-2507 - Phone
- (999) 000-0000
- NPI assigned
- May 24, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 01023960A | IN | Primary |
Addresses
Primary practice location
11 Titcomb St
Newburyport, MA 01950-2507
Mailing address
11 Titcomb St
Newburyport, MA 01950-2507
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000084426 | Other | IN | ANTHEM |
| 4359775 | Other | IN | AETNA |
| 100323800 | Medicaid | IN | |
| 2047381003 | Other | IN | CIGNA |
| 791101024 | Other | IN | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01023960A | IN | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MG Anesthesia, LLC | Past | Accepting new patients |
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.
-
- Anesthesiology Physician
- South Bend, IN
- NPI 1942647219
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1116892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463616000000",
"number": "1427051366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 TITCOMB ST",
"city": "NEWBURYPORT",
"state": "MA",
"postal_code": "019502507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 TITCOMB ST",
"city": "NEWBURYPORT",
"state": "MA",
"postal_code": "019502507",
"telephone_number": "999-000-0000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'DEA",
"first_name": "PATRICK",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-05-24",
"last_updated": "2016-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "IN",
"license": "01023960A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000084426",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4359775",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100323800",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "2047381003",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "791101024",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newburyport, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.