npidexNPI registry + Medicare data

CRYSTAL ODEGARD, PA-C

Physician Assistant · EAGLE, ID

Individual Active Opted out of Medicare NPI 1962081810

Taxonomy & licensure

SpecialtyCodePrimaryLicenseState
Physician Assistant363A00000X✓PA-1982ID

Medicare eligibility

Part B
Yes
DME
Yes
Home health
Yes
Power mobility
Yes
Hospice
No

Opted out of Medicare (Physician Assistant), effective 2021-09-09 through 2027-09-09.

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Source: NPPES (public domain) and CMS Medicare Physician & Other Practitioners data. Not affiliated with CMS, NPPES, or any government agency.