Individual provider Active NPI

Michael O'Donnell, M.D.

  • Gastroenterology Physician
  • Newton, MA
National Provider Identifier
1609223676
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
291965 Issued in MA
Practice address
2000 Washington St
Newton, MA 02462-1650
Phone
(617) 969-1227
NPI assigned
May 19, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 297811 NY
Student in an Organized Health Care Education/Training Program 390200000X
Gastroenterology Physician 207RG0100X 291965 MA Primary

Addresses

Primary practice location

2000 Washington St
Newton, MA 02462-1650

Mailing address

2000 Washington St
Newton, MA 02462-1650
Phone (617) 969-1227

Other practice location 1

15 York St
YNHH Dept of Medicine, LMP 1092
New Haven, CT 06510-3221
Phone (203) 688-5555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20221213000721 MA Practitioner - Gastroenterology 0446544142 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
New York University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Gastroenterology Healthcare Associates PCGroup PAC ID 6709832900, 10 clinicians

Practice addresses (Care Compare)

2000 Washington St
Suite 368
Newton, MA 02462-1627
Phone (617) 969-1227

Hospital & facility affiliations

  • Newton-Wellesley Hospital Hospital, Newton, MA, CCN 220101
  • Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110
  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy299
Upper gastrointestinal (GI) endoscopy for acid reflux151

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
291965MAMDGastroenterology Physician
297811NYMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Gastroenterology Healthcare Associates PC Gastroenterology CurrentSince Aug 23, 2022 Accepting new patients
Pratt Medical Group, Inc PastSince Aug 23, 2022 Accepting new patients

Locations

2000 Washington St
Ste 368
Newton Lower Falls, MA 02462
Phone (617) 965-7554

Organizations & group practices 2

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 3

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": "1463616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1609223676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 WASHINGTON ST",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024621650",
            "telephone_number": "617-969-1227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 WASHINGTON ST",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024621650",
            "telephone_number": "617-969-1227"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 York St",
            "address_2": "YNHH Dept of Medicine, LMP 1092",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065103221",
            "country_code": "US",
            "telephone_number": "203-688-5555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'DONNELL",
        "first_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-19",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "297811",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MA",
            "license": "291965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, MA

Sources for this page

Verify at the official NPI Registry.