Individual provider Active NPI

Evan O'Dea, M.D.

  • Anesthesiology Physician
  • Honolulu, HI
National Provider Identifier
1790210276
Registry record updated Mar 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD-21296 Issued in HI
Practice address
1329 Lusitana St Ste 604
Honolulu, HI 96813-2431
Phone
(808) 531-1116
NPI assigned
Apr 21, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2022

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 MD-21296 HI Primary

Addresses

Primary practice location

1329 Lusitana St Ste 604
Honolulu, HI 96813-2431

Mailing address

1329 Lusitana St Ste 604
Honolulu, HI 96813-2431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210616003115 HI Practitioner - Anesthesiology 4284982315 Reassigns benefits to 1 organization
I20230829004104 OR Practitioner - Anesthesiology 4284982315 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Island Medical Consultants LLCGroup PAC ID 2264696681, 21 clinicians
Oregon Anesthesiology Group PCGroup PAC ID 3476451659, 239 clinicians

Practice addresses (Care Compare)

1301 Punchbowl St
Honolulu, HI 96813-2402
Phone (808) 531-1116

2801 N Gantenbein Ave
Portland, OR 97227-1623
Phone (503) 299-9906

91 -2127 Fort Weaver Rd
Ewa Beach, HI 96706-1993
Phone (808) 531-1116

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Associates Northwest LLC Anesthesiology CurrentSince Jan 1, 2024 Accepting new patients
Oregon Anesthesiology Group PC Anesthesiology CurrentSince Sep 3, 2024 Accepting new patients
Island Medical Consultants, LLC Anesthesiology CurrentSince Jul 26, 2021 Accepting new patients

Locations

1301 Punchbowl St
Honolulu, HI 96813
Phone (808) 538-9011

1329 Lusitana St
Ste 604
Honolulu, HI 96813
Phone (808) 351-1116

2865 Daggett Ave
Klamath Falls, OR 97601
Phone (541) 833-6221

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

120 NW 14th Ave
Ste 200
Portland, OR 97209
Phone (503) 771-1883

707 SW Washington St
Ste 700
Portland, OR 97205

1015 NW 22nd Ave
Portland, OR 97210
Phone (503) 413-7582

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 4

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": "1492732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646438400000",
    "number": "1790210276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1329 LUSITANA ST STE 604",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1329 LUSITANA ST STE 604",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132431",
            "telephone_number": "808-531-1116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DEA",
        "first_name": "EVAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-21",
        "last_updated": "2022-03-05",
        "certification_date": "2022-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "HI",
            "license": "MD-21296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.