Colin Magnuson O'Dea, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MT193425 Issued in PA

Practice address

Broad and Vine Streets
Mail Stop 623
Philadelphia, PA 19102

Phone

(215) 762-2618

NPI assigned

Jul 16, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Emergency Medicine Services of TX, PLLC

  • Emergency Medicine Physician
  • San Antonio, TX
  • NPI 1245938729
  Medicare reassignment NPD

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

{
    "created_epoch": "1216166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216166400000",
    "number": "1992969117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1614 MOUNT VERNON ST",
            "address_2": "APT 2",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191303340",
            "telephone_number": "812-219-0066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BROAD AND VINE STREETS",
            "address_2": "MAIL STOP 623",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19102",
            "telephone_number": "215-762-2618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DEA",
        "first_name": "COLIN",
        "middle_name": "MAGNUSON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-16",
        "last_updated": "2008-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MT193425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Molly O'Connor, M.S., CCC-SLP
• Nancy J O'Connor, CRNP
• Nina R. O'Connor, MD
• Tanis Arinn O'Connor, ARNP
• Oisin Aoghan O'Corragain, MD
• Una T O'Doherty, MD
• Brian William O'Donnell, DO
• Brighid O'Donnell
• Helen Maria McIlhenny O'Donnell, MD
• Kenneth Francis O'Donnell, PHARMD

• Emergency Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Emergency Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.