Individual provider Active NPI

Janet A Odondi, MD

  • Anesthesiology Physician
  • Passaic, NJ
National Provider Identifier
1730164302
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MA07912300 Issued in NJ
Practice address
350 Boulevard
Passaic, NJ 07055-2840
Phone
(973) 779-7361
Fax
(973) 779-7385
NPI assigned
Dec 7, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 25MA07912300 NJ Primary

Addresses

Primary practice location

350 Boulevard
Passaic, NJ 07055-2840

Mailing address

PO Box 1258
Clifton, NJ 07012-0758
Phone (973) 779-7361

Other identifiers 1

IdentifierTypeStateIssuer
0083143MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20100325001093 WA Practitioner - Anesthesiology 6709848336 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Wa Anesthesia Services, PCGroup PAC ID 9335298884, 85 clinicians

Practice addresses (Care Compare)

1321 Colby Ave
Everett, WA 98201-1665
Phone (914) 491-9495

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
74.5 of 100Reported as group
Quality
70
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA07912300NJMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Wa Anesthesia Services, P.C. Anesthesiology CurrentSince Mar 1, 2010 Accepting new patients
Montefiore Medical Center Anesthesiology Past Accepting new patients
County Wide Anesthesia Group, LLC Past Accepting new patients

Locations

1321 Colby Ave
Everett, WA 98201
Phone (425) 259-4413

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 2

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": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730164302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1258",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070120758",
            "telephone_number": "973-779-7361",
            "fax_number": "973-779-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 BOULEVARD",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070552840",
            "telephone_number": "973-779-7361",
            "fax_number": "973-779-7385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODONDI",
        "first_name": "JANET",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA07912300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0083143",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Passaic, NJ

Sources for this page

Verify at the official NPI Registry.