NPIMap

Individual provider Active NPI

Odai Qasim a Abudager Khamash, MD

  • Anesthesiology Physician
  • Harrisburg, PA
National Provider Identifier
1689241846
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD486596 Issued in PA
Practice address
111 South Front Street
Harrisburg, PA 17101-2010
Phone
(717) 782-5118
Fax
(717) 782-5854
NPI assigned
Jun 7, 2021
Reactivated
Dec 23, 2024
Last updated
Mar 26, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Anesthesiology Physician 207L00000X MD486596 PA Primary

Addresses

Primary practice location

111 South Front Street
Harrisburg, PA 17101-2010

Mailing address

111 South Front Street
Harrisburg, PA 17101-2010
Phone (717) 782-5118

Other practice location 1

1901 First Avenue (at 97th Street)
New York, NY 10029
Phone (212) 423-7407

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250328003137 PA Practitioner - Anesthesiology 9032632104 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

111 S Front St
Harrisburg, PA 17101-2010
Phone (717) 782-3282

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD486596PAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Upmc Pinnacle Anesthesia Services, LLC Anesthesiology CurrentSince Mar 1, 2025 Accepting new patients
Upmc Pinnacle Anesthesia Services, LLC CurrentSince Mar 1, 2025 Accepting new patients

Locations

111 S Front St
Harrisburg, PA 17101
Phone (717) 782-3282

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1623024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1689241846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 SOUTH FRONT STREET",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171012010",
            "telephone_number": "717-782-5118",
            "fax_number": "717-782-5854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 SOUTH FRONT STREET",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171012010",
            "telephone_number": "717-782-5118",
            "fax_number": "717-782-5854"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1901 First Avenue (at 97th Street)",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10029",
            "country_code": "US",
            "telephone_number": "212-423-7407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAMASH",
        "first_name": "ODAI",
        "middle_name": "QASIM A ABUDAGER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-07",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "deactivation_date": "2023-04-03",
        "reactivation_date": "2024-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MD486596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.