Individual provider Active NPI

Odessa Marion Williams, AGPCNP-BC

  • Adult Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1992193395
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
306601 Issued in NY
Practice address
300 E 66TH St
New York, NY 10065-6800
Phone
(646) 888-5490
NPI assigned
Jan 7, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 306601 NY Primary

Addresses

Primary practice location

300 E 66TH St
New York, NY 10065-6800

Mailing address

6255 W Sunset Blvd FL 21
Los Angeles, CA 90028-7422
Phone (323) 860-5200

Other practice location 1

475 Atlantic Ave Ste 2
Brooklyn, NY 11217-4383
Phone (917) 246-7498

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20150720001219 NY Practitioner - Nurse Practitioner 5395058432 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Memorial Solid Tumor GroupGroup PAC ID 4082503354, 233 clinicians

Practice addresses (Care Compare)

1275 York Ave
New York, NY 10021-6007
Phone (212) 639-2131

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.5 of 100Reported as group
Quality
60.62
Improvement activities
40
Cost
73.87

Merit-based Incentive Payment System (MIPS)

Final score
86.55 of 100Reported as group
Quality
82.52
Improvement activities
40
Cost
72.02

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Jun 1, 2015 Accepting new patients
Memorial Medical Consultation Group CurrentSince Feb 25, 2020 Accepting new patients
MSK Harrison CurrentSince Aug 25, 2020 Accepting new patients
MSK Nassau CurrentSince May 1, 2024 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jun 1, 2015 Accepting new patients
Memorial Solid Tumor Group CurrentSince Aug 22, 2016 Accepting new patients
Ajs Brooklyn Medical Practice PC CurrentSince Jun 29, 2024 Accepting new patients
MVP Medical Practice PC Current Accepting new patients

Locations

6255 W Sunset Blvd
Fl 21
Los Angeles, CA 90028
Phone (323) 860-5200

475 Atlantic Ave
Ste 2
Brooklyn, NY 11217
Phone (718) 369-4850

5 E 98th St
Fl 12
New York, NY 10029
Phone (212) 241-8303

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

633 3rd Ave
Fl 4
New York, NY 10017
Phone (646) 227-3764

1176 5th Ave
New York, NY 10029
Phone (212) 241-6237

30 W 60th St
Apt An
New York, NY 10023
Phone (212) 247-6575

300 E 66th St
New York, NY 10065
Phone (347) 798-8856

1101 Hempstead Tpke
Uniondale, NY 11553
Phone (516) 559-1000

500 Westchester Ave
West Harrison, NY 10604
Phone (914) 367-7000

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: owilliams21696@mskcc.direct-ci.com

Organizations & group practices 8

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": "1420588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1992193395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6255 W SUNSET BLVD FL 21",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900287422",
            "telephone_number": "323-860-5200",
            "fax_number": "323-467-7119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E 66TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656800",
            "telephone_number": "646-888-5490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "475 Atlantic Ave Ste 2",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112174383",
            "country_code": "US",
            "telephone_number": "917-246-7498",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "ODESSA",
        "middle_name": "MARION",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-07",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "306601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.