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

Ebenezer Kofi Bentum Odoom, MD

Individual provider Geriatric Medicine (Internal Medicine) Physician · NPI 1154416691

Ebenezer Kofi Bentum Odoom, MD is an Internal Medicine in Queens Village, New York. Qualified in 1993, 33 years ago. Practices with Primary Partnercare Physicians PLLC, an 18-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
33
Licensed in
NY
In the registry since
2006
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

21530 Hillside Ave
Queens Village, NY 11427-1831
Phone: (718) 740-1701
Fax: (718) 740-1901
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Geriatric Medicine (Internal Medicine) Physician (primary) Taxonomy 207RG0300X · Licence 230787 (NY)

Record details

NPI number1154416691
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedOctober 3, 2006
Last updated in NPPESOctober 23, 2024
Certification dateOctober 23, 2024

Medicare enrollment

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

Medicare specialtyINTERNAL MEDICINE
Also practisesGERIATRIC MEDICINE, PEDIATRIC MEDICINE
Medical schoolOTHER
Graduated 1993 (33 years in practice)
Group practice Primary Partnercare Physicians Pllc — 18 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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