DR. ODINAKA C ANYANWU (M.D.) – Family Medicine Physician, NPI 1053843482
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
406 FAMILY PRACTICE in RI
Provider Addresses for DR. ODINAKA C ANYANWU (M.D.)
186 Providence St
West Warwick, RI 028932508
Phone: (401) 615-2800
Type: Location
111 Brewster St
Pawtucket, RI 028604400
Phone: (401) 729-2304
Fax: (401) 729-2923
Type: Location
455 Toll Gate Rd
Warwick, RI 028862759
Phone: (401) 737-7010
Fax: (401) 736-4546
Type: Location
1000 Broad St
Central Falls, RI 028631507
Phone: (215) 800-2848
Type: Location
University of Texas Southwestern Medical Center, 5323, Harry Hines Boulevard, Dallas, TX, Dallas, Dallas County, Texas, 75390, United States
DALLAS, TX 753907201
Phone: (215) 439-0656
Type: Location
455 TOLL GATE ROAD
PRC AND CREDENTIALING
WARWICK, RI 028862759
Phone: (401) 273-0641
Fax: (401) 273-2919
Type: Mailing
21 DIVISION ST
PAWTUCKET, RI 028605352
Phone: (401) 727-4800
Fax: (401) 921-6924
Type: Location
1000 BROAD ST
CENTRAL FALLS, RI 028631507
Phone: (215) 800-2848
Type: Location
455 TOLL GATE RD
WARWICK, RI 028862759
Phone: (401) 273-0641
Fax: (401) 273-2919
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2020-11-19
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 |
|---|---|---|---|---|
| I20201119001930 | I | Family Practice | RI | 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 02893)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | RI | |
| Clinical Social Worker | RI | |
| Physician Assistant | RI | |
| Nurse Practitioner | RI | |
| Physician Assistant | MA | |
| Family Practice | RI | |
| Physician Assistant | RI | |
| Family Practice | RI | |
| Nurse Practitioner | MA | |
| Family Practice, Nurse Practitioner | MD |
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