ANDREW WILLIAM ODEGAARD (MD) – Family Medicine Physician, NPI 1669095790

ANDREW WILLIAM ODEGAARD (MD) is a healthcare provider. based in Monticello, Georgia. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. 12178 (GA). The NPI Number for ANDREW WILLIAM ODEGAARD (MD) is 1669095790

Main info

Male
6 Years Of Experience
Accepts Medicare Assignment
Name
ANDREW WILLIAM ODEGAARD (MD)
NPI
1669095790
Phone
(770) 714-3231
Address
780 BRAGG RD
Enumeration Date
23 May 2020
Last Update Date
12 August 2021

Doctor Profile

Medical School Name
MERCER UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
7064680988
Graduation Year
2020 (6 years ago)
PAC ID
7810302056
Group Practice PAC ID
7214901230
Professional Enrollment ID
I20230921003866
Address ID
GA310641258MO898XXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness75
Years active:6State licenses:1Digital endpointsOther names

3,102 FAMILY PRACTICE in GA

Provider Addresses for ANDREW WILLIAM ODEGAARD (MD)

  • 780 BRAGG RD

    MONTICELLO, GA 310645146

    Phone: (770) 714-3231

    Type: Mailing

  • 729 PINE ST

    MACON, GA 312012106

    Phone: (478) 633-1634

    Type: Location

  • 3780 EISENHOWER PKWY

    MACON, GA 312060800

    Phone: (478) 633-5500

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 12 Open Payments records for all available years, with a total value of $230.

Total Amount is formed as General ($230) + Research ($0) + Ownership ($0) = $230.

Last reported payment date: 2024-11-20 • Largest payer in this snapshot: ABBVIE INC. ($48).

Total Amount

$230

General + Research + Ownership

Payments

12

Total payment records

General Amount

$230

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-20

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2023-09-21

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230921003866IFamily PracticeGATBD

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.

Verify on CMS Revalidation Lookup Tool

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 31064)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7214901230View full group profile
NameSpecialtyState
Physician AssistantGA
Nurse PractitionerGA
Physician AssistantGA
Physician AssistantGA
Family PracticeGA

Reviews

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Frequently asked questions

What is the registry number for ANDREW WILLIAM ODEGAARD (MD)?
The registry entry for ANDREW WILLIAM ODEGAARD (MD) shows NPI 1669095790.
Is ANDREW WILLIAM ODEGAARD (MD)'s NPI status active today?
Active status means ANDREW WILLIAM ODEGAARD (MD)'s NPI record is not deactivated in the public file.
How should patients interpret ANDREW WILLIAM ODEGAARD (MD)'s specialty?
The extract shows Family Medicine Physician for ANDREW WILLIAM ODEGAARD (MD). Clinical services aligned with this taxonomy classification.
What geographic area is tied to ANDREW WILLIAM ODEGAARD (MD)?
ANDREW WILLIAM ODEGAARD (MD) is associated with Monticello, Georgia in the same public data insurers reference.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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