Individual provider Active NPI

Carmel M Odonnell, M.D.

  • Internal Medicine Physician
  • Pitman, NJ
National Provider Identifier
1497754097
Registry record updated Feb 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MB08097600 Issued in NJ
Practice address
410 N Broadway
Suite 1
Pitman, NJ 08071-1047
Phone
(856) 589-3708
Fax
(856) 589-2662
NPI assigned
Jul 18, 2005
Last updated
Feb 6, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MB08097600 NJ Primary

Addresses

Primary practice location

410 N Broadway
Suite 1
Pitman, NJ 08071-1047

Mailing address

410 N Broadway
Suite 1
Pitman, NJ 08071-1047
Phone (856) 589-3708

Other identifiers 1

IdentifierTypeStateIssuer
0190292MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20070625000693 NJ Practitioner - Internal MedicinePractitioner - Family Practice 6800875717 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanticare Physician Group PA CurrentSince Aug 1, 2018 Accepting new patients
Salem Medical Professionals PC Internal Medicine Past Accepting new patients
Ambulatory United Past Accepting new patients
Fast Doc LLC Internal Medicine Past Accepting new patients
Inspira Health Network Urgent Care, P.C. Past Accepting new patients
Rowansom Dept of General Internal Medicine Internal Medicine Past Accepting new patients

Locations

459 Route 9 S
Little Egg Harbor Twp, NJ 08087
Phone (609) 340-7815

1613 Route 47 S
Unit F
Rio Grande, NJ 08242
Phone (609) 886-5245

Interoperability endpoints

  • Direct secure messaging: carmel.odonnell@49428401684484.direct.elationemr.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360108800000",
    "number": "1497754097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 N BROADWAY",
            "address_2": "SUITE 1",
            "city": "PITMAN",
            "state": "NJ",
            "postal_code": "080711047",
            "telephone_number": "856-589-3708",
            "fax_number": "856-589-2662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 N BROADWAY",
            "address_2": "SUITE 1",
            "city": "PITMAN",
            "state": "NJ",
            "postal_code": "080711047",
            "telephone_number": "856-589-3708",
            "fax_number": "856-589-2662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODONNELL",
        "first_name": "CARMEL",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-18",
        "last_updated": "2013-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MB08097600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0190292",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pitman, NJ

Sources for this page

Verify at the official NPI Registry.