Active NPI
Thaddaeus Walter Josef Odermatt, M.D.
- Anesthesiology Physician
- San Francisco, CA
National Provider Identifier
1558503326
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- F5521
- Practice address
- 505 Parnassus Ave
San Francisco, CA 94143-2204 - Phone
- (415) 476-1000
- NPI assigned
- Mar 25, 2009
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | F5521 | CA | Primary |
Addresses
Primary practice location
505 Parnassus Ave
San Francisco, CA 94143-2204
Mailing address
130 Frederick St
Apt 302
San Francisco, CA 94117-4056
Phone (415) 216-5025
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 |
|---|---|---|---|
| F5521 | CA | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1237939200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1237939200000",
"number": "1558503326",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 FREDERICK ST",
"address_2": "APT 302",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941174056",
"telephone_number": "415-216-5025",
"fax_number": "415-476-9516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "505 PARNASSUS AVE",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941432204",
"telephone_number": "415-476-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ODERMATT",
"first_name": "THADDAEUS",
"middle_name": "WALTER JOSEF",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-03-25",
"last_updated": "2009-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CA",
"license": "F5521",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.