JOHN ODOM (MD) – Sports Medicine (Physical Medicine & Rehabilitation) Physician, NPI 1215953732
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,075 FAMILY PRACTICE in MN
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Provider Addresses for JOHN ODOM (MD)
WayzAta Blvd, Cheshire Lane, Minnetonka, Hennepin County, Minnesota, 55305:55391, United States
MINNETONKA, MN 553051511
Phone: (952) 224-1919
Type: Location
6545 FLYING CLOUD DR STE 201
EDEN PRAIRIE, MN 553443356
Phone: (952) 224-1919
Fax: (612) 999-1943
Type: Location
10653 WAYZATA BLVD STE 200
MINNETONKA, MN 553051543
Phone: (952) 224-1919
Type: Location
Pleasant View Cove, Willow Ridge, Chanhassen, Carver County, Minnesota, 55317, United States
CHANHASSEN, MN 553179263
Phone: (952) 906-2011
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $16.
Total Amount is formed as General ($16) + Research ($0) + Ownership ($0) = $16.
Last reported payment date: 2024-08-20 • Largest payer in this snapshot: Fidia Pharma USA Inc. ($16).
Total Amount
$16
General + Research + Ownership
Payments
1
Total payment records
General Amount
$16
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Fidia Pharma USA Inc. | $16 |
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: 2004-09-27
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 |
|---|---|---|---|---|
| I20040927000127 | I | Family Practice | MN | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 56 | 28 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 25 | 25 | $0 |
Insurance plans in this area (ZIP 55305)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Qualified Speech Language Pathologist | MN | |
| - | MN | |
| Physical Therapist In Private Practice | MN | |
| Occupational Therapist In Private Practice | MN | |
| Physical Therapist In Private Practice | MN | |
| - | MN | |
| - | MN | |
| - | MN | |
| Occupational Therapist In Private Practice | MN | |
| Physical Therapist In Private Practice | IL |
Reviews
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