Individual provider Active NPI

Anne Odom McEvoy, M.D.

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • San Diego, CA
National Provider Identifier
1861888471
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
A196492 Issued in CA
Practice address
3020 Childrens Way
San Diego, CA 92123-4223
Phone
(858) 966-8800
NPI assigned
Apr 9, 2015
Last updated
Jul 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X 321435-01 NY
Pediatrics Physician 208000000X A196492 CA
Pediatrics Physician 208000000X 0101264038 VA
Pediatrics Physician 208000000X 2275498 NY
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X A196492 CA Primary

Addresses

Primary practice location

3020 Childrens Way
San Diego, CA 92123-4223

Mailing address

3020 Childrens Way # Mc5003
San Diego, CA 92123-4223
Phone (858) 309-6300

Other practice location 1

25500 Medical Center Dr
Murrieta, CA 92562-5965
Phone (951) 696-6000

Other names 1

  • Anne Alexandra Odom Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, NY, CA3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20180712001950 VA Practitioner - Pediatric Medicine 9931409364 Reassigns benefits to 2 organizations
I20230922002312 NY Practitioner - Pediatric Medicine 9931409364 Reassigns benefits to 1 organization
I20250108003403 CA Practitioner - Emergency Medicine 9931409364 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
321435-01NYMDPediatric Emergency Medicine (Emergency Medicine) Physician
2275498NYMDPediatrics Physician
A196492CAMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Aug 12, 2023 Accepting new patients
Childrens Specialty Group PLLC Pediatrics CurrentSince Jul 1, 2018 Accepting new patients
Childrens Hospital of the Kings Daughters Inc CurrentSince Apr 1, 2019 Accepting new patients
Rady Children's Hospital San Diego Pediatrics CurrentSince Oct 31, 2024 Accepting new patients
Rady Children's Hospital San Diego CurrentSince Oct 31, 2024 Accepting new patients
Marilyn Kaufhold, M.D., a Medical Corporation Past Accepting new patients

Locations

25170 Hancock Ave
Murrieta, CA 92562
Phone (858) 966-8300

25500 Medical Center Dr
Murrieta, CA 92562
Phone (951) 696-6000

3020 Childrens Way
San Diego, CA 92123
Phone (858) 966-5841

3020 Childrens Way
#5003
San Diego, CA 92123
Phone (858) 309-6300

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

26019 Nassau Blvd
Little Neck, NY 11362
Phone (516) 488-2880

300 Community Dr
Manhasset, NY 11030

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

26901 76th Ave
Ste CH5
New Hyde Park, NY 11040
Phone (718) 470-3953

817 Volvo Pkwy
Chesapeake, VA 23320
Phone (757) 668-4630

601 Childrens Ln
Norfolk, VA 23507
Phone (757) 668-7272

1924 Landstown Centre Way
Ste 103
Virginia Beach, VA 23456

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1428537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1861888471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 CHILDRENS WAY # MC5003",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "858-309-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 CHILDRENS WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "858-966-8800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25500 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Murrieta",
            "state": "CA",
            "postal_code": "925625965",
            "country_code": "US",
            "telephone_number": "951-696-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCEVOY",
        "first_name": "ANNE",
        "middle_name": "ODOM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-09",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "NY",
            "license": "321435-01",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A196492",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101264038",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "2275498",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "CA",
            "license": "A196492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNE",
            "last_name": "ODOM",
            "middle_name": "ALEXANDRA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.