Individual provider Active NPI

Charles A. Odonkor, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Old Saybrook, CT
National Provider Identifier
1457797755
Registry record updated Feb 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
61239 Issued in CT
Practice address
633 Middlesex Tpke
Old Saybrook, CT 06475-1220
Phone
(877) 925-3637
Fax
(203) 785-6798
NPI assigned
May 14, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 61239 CT Primary
Orthopaedic Surgery Physician 207X00000X 61239 CT

Addresses

Primary practice location

633 Middlesex Tpke
Old Saybrook, CT 06475-1220

Mailing address

47 College St FL 2
New Haven, CT 06510-3209
Phone (877) 925-3637

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20190924001142 CT Practitioner - Physical Medicine and Rehabilitation 3678858081 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Yale University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

111 Goose LN
Guilford, CT 06437-5101
Phone (203) 747-7300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.36 of 100Reported as group
Quality
77.36
Promoting interoperability
100
Improvement activities
40
Cost
74.27

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61239CTMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University Orthopaedic Surgery CurrentSince Sep 4, 2019 Accepting new patients
Yale University CurrentSince Sep 4, 2019 Accepting new patients
Yale University Orthopaedic Surgery Current Accepting new patients

Locations

111 Goose Ln
Guilford, CT 06437
Phone (203) 453-7100

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

300 George St
Fl 6
New Haven, CT 06511
Phone (203) 785-6610

633 Middlesex Tpke
Old Saybrook, CT 06475
Phone (860) 388-5831

Interoperability endpoints

  • Direct secure messaging: codonkor33246@direct.ynhh.org

Organizations & group practices 3

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 5

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": "1368489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771459200000",
    "number": "1457797755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 COLLEGE ST FL 2",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103209",
            "telephone_number": "877-925-3637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 MIDDLESEX TPKE",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064751220",
            "telephone_number": "877-925-3637",
            "fax_number": "203-785-6798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODONKOR",
        "first_name": "CHARLES",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-14",
        "last_updated": "2026-02-19",
        "certification_date": "2026-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CT",
            "license": "61239",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CT",
            "license": "61239",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Saybrook, CT

Sources for this page

Verify at the official NPI Registry.