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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: November 01, 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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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., Oscar Health and more.Insurance ›

Medicare Participation & PECOS CMS

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

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.

Medicare Billing Reassignment

Medicare enrollment records show Fatima Odetalla reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Amber Benson Pmhnp PC
2,467 mi
Psychiatric/Mental Health
66 CLUB RD STE 160
Eugene, OR 97401
  • Reassigned Medicare billing, Oregon enrollment
  • 35 clinicians in this Medicare group
NPI 1912042862 (541) 345-1722

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 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.

Which organization bills Medicare for Fatima Odetalla's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Fatima Odetalla reassigns Medicare benefits to Amber Benson Pmhnp PC (Eugene, OR). The 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 Fatima Odetalla's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Fatima Odetalla accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., Oscar Health, Providence Health Plan and Regence BlueCross BlueShield of Oregon list Fatima Odetalla 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 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.