Robert Larbi-Odam, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

46773 Issued in MN

Practice address

6014 Lakeland Ave N
Crystal, MN 55428-2984

Phone

(612) 871-2312

Fax

(612) 871-2163

NPI assigned

Mar 24, 2006

Last updated

Mar 31, 2023By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Family Practice

Education

University of Minnesota Medical School, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Odam Medical GroupGroup PAC ID 4082911938, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Odam Medical Group

  • Clinic/Center
  • Crystal, MN
  • NPI 1578934683
  Medicare reassignment Care Compare group Authorized official
• Odam Community Clinics

  • Primary Care Clinic/Center
  • Minneapolis, MN
  • NPI 1194437061
  Medicare reassignment Authorized official
• Odam Medical Group

  • Primary Care Clinic/Center
  • Foley, MN
  • NPI 1538059779
  NPD Authorized official
• Odam Medical Group

  • Primary Care Clinic/Center
  • Saint Cloud, MN
  • NPI 1902392525
  NPD Authorized official
• Odam Medical Group

  dba Odam Medical Group Moorhead

  • Primary Care Clinic/Center
  • Moorhead, MN
  • NPI 1366241309
  NPD (past) Authorized official

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680220800000",
    "number": "1457311409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6014 LAKELAND AVE N",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554282984",
            "telephone_number": "612-871-2312",
            "fax_number": "612-871-2163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6014 LAKELAND AVE N",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554282984",
            "telephone_number": "612-871-2312",
            "fax_number": "612-871-2163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARBI-ODAM",
        "first_name": "ROBERT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "46773",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "660270300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth E Kuettner, MC, LPC, CPRP
• Bethany S Kunkel, LPCC
• Mary K Laconic, OD
• Aaron Thomas Lahoud, O.D.
• Lisa Lapointe, PA-C
• Katherine McCourt Robinson Larson, PA C
• Yehudis Rena Last
• Luca Oliver Lavallee
• Stephanie Albrecht Lee, PHYSICIAN ASSISTANT
• Lisa Legvold, PA-C

• Family Medicine Physician in Crystal, MN
• Providers in Crystal, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.