CHISOM CHIJIOKE ODOGWU – Physician Assistant, NPI 1346801362
Physician Assistant
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Profile Insights
NPPES metrics only — not quality of care.
4,431 PHYSICIAN ASSISTANT in GA
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Provider Addresses for CHISOM CHIJIOKE ODOGWU
1679 PINTO TRL
JONESBORO, GA 302365189
Phone: (678) 577-6194
Type: Mailing
20, Glenlake Parkway Northeast, Atlanta, Fulton County, Georgia, 30328, United States
ATLANTA, GA 303283473
Phone: (800) 611-1811
Type: Location
135 N PARK PL STE 101
STOCKBRIDGE, GA 302817237
Phone: (770) 758-7493
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 38 Open Payments records for all available years, with a total value of $1,757.
Total Amount is formed as General ($1,757) + Research ($0) + Ownership ($0) = $1,757.
Last reported payment date: 2024-12-18 • Largest payer in this snapshot: 4WEB, INC. ($1,618).
Total Amount
$1,757
General + Research + Ownership
Payments
38
Total payment records
General Amount
$1,757
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| 4WEB, INC. | $1,618 |
| Heron Therapeutics, Inc. | $66 |
| DePuy Synthes Sales Inc. | $34 |
| Bioventus LLC | $25 |
| MEDACTA USA, INC. | $15 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-09-30
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190930003346 | I | Physician Assistant | GA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30236)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| N E U R O S U R G E R Y | FL | |
| Nurse Practitioner | GA | |
| General Surgery | GA | |
| Colorectal Surgery (Proctology) | GA | |
| - | GA | |
| - | GA | |
| Vascular Surgery | GA | |
| - | GA | |
| - | GA | |
| - | GA |
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