Individual provider Active NPI

Esther Odagbodo

  • Physician Assistant
  • Washington, DC
National Provider Identifier
1831859685
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0008258 Issued in MD
Practice address
1160 Varnum St NE Ste 117
Washington, DC 20017-2106
Phone
(202) 831-7007
Fax
(202) 529-5290
NPI assigned
Dec 21, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0008258 MD Primary

Addresses

Primary practice location

1160 Varnum St NE Ste 117
Washington, DC 20017-2106

Mailing address

2905 Mitchellville Rd Ste 102
Bowie, MD 20716-3951

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20220121000586 DC Practitioner - Physician Assistant 6305238437 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Privia Care Center LLCGroup PAC ID 3274801139, 286 clinicians

Practice addresses (Care Compare)

12150 Annapolis Rd
Suite 300
Glenn Dale, MD 20769-9183
Phone (301) 249-5384

4910 Massachusetts Ave NW
Suite 114 Grady DC Office
Washington, DC 20016-4384
Phone (202) 686-0813

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C0008258MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC Family Medicine CurrentSince Apr 22, 2024 Accepting new patients
Privia Medical Group, LLC CurrentSince Apr 22, 2024 Accepting new patients
Privia Care Center LLC Internal Medicine CurrentSince Apr 22, 2024 Accepting new patients
Nova Physician Wellness Center PLLC Family Medicine Past Accepting new patients

Locations

4910 Massachusetts Ave NW
Ste 114
Washington, DC 20016
Phone (202) 244-0812

12150 Annapolis Rd
Ste 300
Glenn Dale, MD 20769
Phone (301) 249-5384

9470 Annapolis Rd
Ste 309
Lanham, MD 20706
Phone (202) 832-1800

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: esther.odagbodo.1@8042.direct.athenahealth.com

Organizations & group practices 6

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": "1640044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1831859685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2905 MITCHELLVILLE RD STE 102",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207163951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 VARNUM ST NE STE 117",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200172106",
            "telephone_number": "202-831-7007",
            "fax_number": "202-529-5290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODAGBODO",
        "first_name": "ESTHER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-21",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0008258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.