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CLEMENTINE S ODAMTTEN NP
NPI 1104340306
Family Medicine in San Jose, CA

Active since July 28, 2017PECOS Enrolled
2498 STEVENS CREEK BLVD, SAN JOSE, CA 95128(408) 998-5400(408) 998-5414 Get Directions Write a Review

NPPES record last updated: July 28, 2017. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Clementine S Odamtten Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CLEMENTINE S ODAMTTEN NP (NPI 1104340306) is an individual family medicine provider in San Jose, California, licensed in California (95006909) and active in the NPI registry since July 2017. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104340306
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameCLEMENTINE S ODAMTTENCredential: NP
Location Address2498 STEVENS CREEK BLVDSan Jose, CA 95128-1652
Mailing Address308 Shaughnessy DrMilpitas, CA 95035-5474 · (571) 524-6265
Phone(408) 998-5400
Fax(408) 998-5414
Sole ProprietorNo
Enumeration DateJuly 28, 2017
✔ NPI 1104340306 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in CA · 95006909
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
2498 STEVENS CREEK BLVD, San Jose, CA 95128
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Clementine S Odamtten Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

4

Medicare enrollment records show Clementine Odamtten reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Zenmedicine
317 mi
General Practice
741 S ORANGE AVE
West Covina, CA 91790
  • Reassigned Medicare billing, California enrollment
  • 18 clinicians in this Medicare group
NPI 1821567488 (626) 960-7117
Clinical Mobile Care
331 mi
Surgery
15145 HAWTHORN AVE
Chino Hills, CA 91709
  • Reassigned Medicare billing, California enrollment
  • 3 clinicians in this Medicare group
NPI 1083405096 (909) 935-9345
Vst Medical
331 mi
Surgery
15145 HAWTHORN AVE
Chino Hills, CA 91709
  • Reassigned Medicare billing, California enrollment
  • 5 clinicians in this Medicare group
NPI 1336939263 (909) 935-9345
Vicrumdeep S Tung MD Inc
331 mi
Surgery
15145 HAWTHORN AVE
Chino Hills, CA 91709
  • Reassigned Medicare billing, California enrollment
  • 4 clinicians in this Medicare group
NPI 1417789181 (909) 935-9345

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95128 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$106.47 typical visit price
range $70.37 – $206.04
Typical copayment $26.61 (range $17.59 – $51.51)
Most-billed visit code 99203
Established Patient
$121.77 typical visit price
range $23.96 – $169.60
Typical copayment $30.44 (range $5.99 – $42.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARJERNELL HICKMAN AGPCNP
Nurse Practitioner (Primary Care)
2498 STEVENS CREEK BLVD
SAN JOSE, CA 95128
Santa Clara County (408) 998-5400
HORIZON MEDICAL CENTER
Family Medicine
2498 STEVENS CREEK BLVD
SAN JOSE, CA 95128
Santa Clara County (408) 356-1111
SUZANNE MAYE APRN
Nurse Practitioner
2498 STEVENS CREEK BLVD
SAN JOSE, CA 95128
Santa Clara County (408) 998-5400

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Clementine Odamtten's NPI number?

The NPI number for Clementine Odamtten is 1104340306. It was assigned to this individual provider in the NPPES registry on July 28, 2017.

Where is Clementine Odamtten located?

Clementine Odamtten practices at 2498 Stevens Creek Blvd, San Jose, CA 95128. The listed phone number is (408) 998-5400.

What is Clementine Odamtten's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Clementine Odamtten enrolled in Medicare?

Yes. Clementine Odamtten is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Clementine Odamtten's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Clementine Odamtten reassigns Medicare benefits to 4 organizations: Zenmedicine (West Covina, CA), Clinical Mobile Care (Chino Hills, CA), Vst Medical (Chino Hills, CA) and Vicrumdeep S Tung MD Inc (Chino Hills, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Clementine Odamtten's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Clementine Odamtten was last updated on July 28, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.