Individual provider Active NPI

Brian William O'Donnell, DO

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1770106593
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS022800 Issued in PA
Practice address
10800 Knights Rd
Philadelphia, PA 19114-4200
Phone
(215) 612-5161
NPI assigned
May 27, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS022800 PA Primary
Student in an Organized Health Care Education/Training Program 390200000X OT019914 PA

Addresses

Primary practice location

10800 Knights Rd
Philadelphia, PA 19114-4200

Mailing address

10800 Knights Rd
Philadelphia, PA 19114-4200
Phone (215) 612-5161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20230705001356 PA Practitioner - Family Practice 5092136804 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aria Health Physician ServicesGroup PAC ID 3577467018, 456 clinicians

Practice addresses (Care Compare)

2469 Grant Ave
Philadelphia, PA 19114-1004
Phone (215) 671-8900

Hospital & facility affiliations

  • Mercy Home Health Home health agency, Newtown, PA, CCN 397015
  • Jefferson Health at Home by Bayada Home health agency, Philadelphia, PA, CCN 397643
  • Holy Redeemer Home Care-PA Home health agency, Philadelphia, PA, CCN 397104
  • Jefferson Health- Northeast Hospital, Philadelphia, PA, CCN 390115
  • Thomas Jefferson University Hospital Hospital, Philadelphia, PA, CCN 390174

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS022800PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aria Health Physician Services CurrentSince Jun 21, 2023 Accepting new patients
Aria Health Physician Services Family Medicine Current Accepting new patients
Aria Health Physician Services Family Medicine CurrentSince Jun 21, 2023 Accepting new patients
Aria Health Physician Services Past Accepting new patients

Locations

240 Middletown Blvd
Ste 101C
Langhorne, PA 19047
Phone (215) 550-9999

9501 Roosevelt Blvd
Ste 206B
Philadelphia, PA 19114
Phone (215) 624-6162

9501 Roosevelt Blvd
Ste 206
Philadelphia, PA 19114
Phone (215) 671-8900

10800 Knights Rd
Philadelphia, PA 19114
Phone (215) 612-2610

5000 Frankford Ave
Ste 1B
Philadelphia, PA 19124
Phone (215) 583-2355

Organizations & group practices 4

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 5

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": "1590537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1770106593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10800 KNIGHTS RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191144200",
            "telephone_number": "215-612-5161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10800 KNIGHTS RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191144200",
            "telephone_number": "215-612-5161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DONNELL",
        "first_name": "BRIAN",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-27",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS022800",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "OT019914",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.