Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Bassam N Odatalla, MD

Individual provider Family Medicine Physician · NPI 1063620060

Dr. Bassam N Odatalla, MD is a Family Practice in Fairfield, New Jersey. Qualified in 2006, 20 years ago. Practices with Hackensack Meridian Urgent Care PC, a 50-clinician group and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
20
Licensed in
NJ
In the registry since
2007
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

200 Fairfield Rd
Fairfield, NJ 07004-2426
Phone: (973) 487-1944
Fax: (973) 487-1945
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 08610800 (NJ)

Record details

NPI number1063620060
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 21, 2007
Last updated in NPPESAugust 19, 2015

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Group practice Hackensack Meridian Urgent Care Pc — 50 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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