Individual provider Active NPI

Stephanie Leanne Odejimi, PA-C

  • Medical Physician Assistant
  • Bronx, NY
National Provider Identifier
1730746579
Registry record updated May 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
600 E 233Rd St
Bronx, NY 10466-2604
Phone
(718) 920-9000
NPI assigned
May 28, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

600 E 233Rd St
Bronx, NY 10466-2604

Mailing address

2971 Daylily Dr
Columbus, IN 47201-5623
Phone (346) 907-8272

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20201202003152 TX Practitioner - Physician Assistant 0446580658 Reassigns benefits to 2 organizations
I20240610002551 MI Practitioner - Physician Assistant 0446580658 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michigan Post-Acute Medical Services 1 PCGroup PAC ID 2163798877, 25 clinicians
Sound Inpatient Physicians-Michigan PLLCGroup PAC ID 5395896849, 168 clinicians

Practice addresses (Care Compare)

11537 Fulton St E
Lowell, MI 49331-9609
Phone (616) 897-8413

1521 Gull Rd
Kalamazoo, MI 49048-1640
Phone (269) 226-7000

22600 W Main St
Armada, MI 48005-3237
Phone (734) 508-4569

580 W College Ave
Up Health System
Marquette, MI 49855-2736
Phone (906) 228-9440

625 36TH St SW
Wyoming, MI 49509-4004
Phone (616) 531-0200

Hospital & facility affiliations

  • Borgess Medical Center Hospital, Kalamazoo, MI, CCN 230117

Merit-based Incentive Payment System (MIPS)

Final score
84.11 of 100Reported as group
Quality
69.15
Promoting interoperability
100
Improvement activities
40
Cost
73.63

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
023767NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
NV Pacs 2 LLC Past Accepting new patients

Organizations & group practices 7

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 1

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": "1559001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559001600000",
    "number": "1730746579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2971 DAYLILY DR",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472015623",
            "telephone_number": "346-907-8272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E 233RD ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104662604",
            "telephone_number": "718-920-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODEJIMI",
        "first_name": "STEPHANIE",
        "middle_name": "LEANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-28",
        "last_updated": "2019-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.