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ODIBO MEDICAL GROUP PLLC
NPI 1710334503
Internal Medicine in Wilmington, NC

Active since May 21, 2016CLIA 34D2114711 · Waiver
1215 MEDICAL CENTER DR, WILMINGTON, NC 28401(910) 228-5894(888) 836-5759 Get Directions Write a Review

NPPES record last updated: October 28, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 6, 2024, Apr 12, 2023, May 21, 2016 (3 updates tracked since 2016).

About Odibo Medical Group Pllc NPPES

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

ODIBO MEDICAL GROUP PLLC (NPI 1710334503) is a healthcare organization registered as an internal medicine in Wilmington, North Carolina and active in the NPI registry since May 2016. The organization holds a CLIA Waiver certificate valid through June 20, 2028 and lists Michael C Odibo, Founder & President, as its authorized official.

NPPES Registry Identity

NPI1710334503
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameODIBO MEDICAL GROUP PLLC
Location Address1215 MEDICAL CENTER DRWilmington, NC 28401-7306
Mailing Address1215 Medical Center DrWilmington, NC 28401-7306 · (910) 228-5894 · Fax (888) 836-5759
Phone(910) 228-5894
Fax(888) 836-5759
Organization SubpartNo
Authorized OfficialMichael C OdiboFounder & President · (973) 727-7409
Enumeration DateMay 21, 2016
Last NPPES UpdateOctober 28, 20243 updates tracked since enumeration
NPPES CertifiedOctober 28, 2024
✔ NPI 1710334503 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
1215 MEDICAL CENTER DR, Wilmington, NC 28401
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Odibo Medical Group Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Odibo Medical Group PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Michael Odibo, M.D.
Internal Medicine
NPI 1144496191
1215 MEDICAL CENTER DR
Wilmington, NC 28401
(910) 228-5894
✔ PECOS✔ Accepts MedicareSame address

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D2114711

Odibo Medical Group, PLLC · Wilmington, NC
Active · expires Jun 20, 2028
CLIA Number34D2114711
Laboratory TypePhysician Office
Certificate Effective DateJune 21, 2026
Certificate Expiration DateJune 20, 2028
Laboratory DirectorMichael C. Odibo
Laboratory Phone(910) 228-5894
Laboratory LocationOdibo Medical Group, PLLC1215 Medical Center Drive, Wilmington, NC 28401
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Odibo Medical Group PLLC's NPI number?

The NPI number for Odibo Medical Group PLLC is 1710334503. It was assigned to this organization in the NPPES registry on May 21, 2016.

Where is Odibo Medical Group PLLC located?

Odibo Medical Group PLLC is located at 1215 Medical Center Dr, Wilmington, NC 28401. The listed phone number is (910) 228-5894.

What is Odibo Medical Group PLLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Odibo Medical Group PLLC enrolled in Medicare?

Yes. Odibo Medical Group PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Odibo Medical Group PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Odibo Medical Group PLLC. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Odibo Medical Group PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D2114711) is associated with this NPI, valid through June 20, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Odibo Medical Group PLLC accept?

Health plans from Blue Cross and Blue Shield of NC list Odibo Medical Group PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Odibo Medical Group PLLC was last updated on October 28, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months 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.