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DR. FATIMA ODETALLA DNP, FNP/PMHNP-BC
NPI 1881005478
Nurse Practitioner - Psychiatric/Mental Health in Suffern, NY

Active since May 16, 2014PECOS Enrolled
65 E MALTBIE AVE, SUFFERN, NY 10901(901) 590-7680 Get Directions Write a Review

NPPES record last updated: November 17, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Fatima Odetalla Dnp, Fnp/pmhnp-bc NPPES

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

DR. FATIMA ODETALLA DNP, FNP/PMHNP-BC (NPI 1881005478) is an individual psychiatric/mental health provider in Suffern, New York, licensed in New York (F401694) and active in the NPI registry since May 2014. She is enrolled in Medicare PECOS and is a graduate of University Of Tennessee, Hsc, College Of Medicine (2013).

NPPES Registry Identity

NPI1881005478
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameDR. FATIMA ODETALLACredential: DNP, FNP/PMHNP-BC
Location Address65 E MALTBIE AVESuffern, NY 10901-6007
Mailing Address65 E Maltbie AveSuffern, NY 10901-6007 · (901) 590-7680
Phone(901) 590-7680
Sole ProprietorYes
Medical School CMSUniversity Of Tennessee, Hsc, College Of MedicineGraduated 2013
Enumeration DateMay 16, 2014
Last NPPES UpdateNovember 17, 2020
NPPES CertifiedNovember 13, 2020
✔ NPI 1881005478 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
Licenses✔ Licensed in NY · F401694✔ Licensed in TN · 18374
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 18374 (TN), F338723 (NY)
65 E MALTBIE AVE, Suffern, NY 10901
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Fatima Odetalla Dnp, Fnp/pmhnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7517263502
PECOS Enrollment IDI20260605002234
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10901 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
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
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.

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 Fatima Odetalla's NPI number?

The NPI number for Fatima Odetalla is 1881005478. It was assigned to this individual provider in the NPPES registry on May 16, 2014.

Where is Fatima Odetalla located?

Fatima Odetalla practices at 65 E Maltbie Ave, Suffern, NY 10901. The listed phone number is (901) 590-7680.

What is Fatima Odetalla's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Fatima Odetalla enrolled in Medicare?

Yes. Fatima Odetalla is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Fatima Odetalla was last updated on November 17, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.