NPIMap

Organization Active NPI

Custom Dietetics, PC

  • Registered Dietitian
  • Williamsville, NY
National Provider Identifier
1063596880
Registry record updated Mar 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
CUSTOM DIETETICS, PC
Practice address
2829 Wehrle Dr Ste 7B
Williamsville, NY 14221-7387
Phone
(716) 626-7415
Fax
(716) 632-0389
NPI assigned
Oct 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Allyson Erica Odachowski, R.D., CDNNPI 1235221557
Title
President/Registered Dietitian
Phone
(716) 626-7415

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
NutritionistGroup: 193200000X MULTI-SPECIALTY GROUP 133N00000X
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X 005917-1 NY
Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133V00000X Primary

Addresses

Primary practice location

2829 Wehrle Dr Ste 7B
Williamsville, NY 14221-7387

Mailing address

2829 Wehrle Dr Ste 7B
Williamsville, NY 14221-7387
Phone (716) 626-7415

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051017000158 NY Part B Supplier - Clinic/Group Practice 1456377738 Receives reassigned benefits from 8 practitioners
Practice locations: Williamsville, NY

National Provider Directory

National Provider Directory

Locations

4498 Main St
Ste 18
Amherst, NY 14226
Phone (716) 839-1883

5360 Genesee St
Ste 201
Bowmansville, NY 14026
Phone (716) 686-3878

8600 Sheridan Dr
Ste 2A
Williamsville, NY 14221
Phone (716) 626-7415

2801 Wehrle Dr
Ste 4
Williamsville, NY 14221
Phone (716) 572-4909

2829 Wehrle Dr
Ste 7B
Williamsville, NY 14221
Phone (716) 626-7415

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774915200000",
    "number": "1063596880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2829 WEHRLE DR STE 7B",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142217387",
            "telephone_number": "716-626-7415",
            "fax_number": "716-632-0389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2829 WEHRLE DR STE 7B",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142217387",
            "telephone_number": "716-626-7415",
            "fax_number": "716-632-0389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM DIETETICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A",
        "authorized_official_last_name": "ODACHOWSKI",
        "authorized_official_first_name": "ALLYSON",
        "authorized_official_middle_name": "ERICA",
        "authorized_official_title_or_position": "PRESIDENT/REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "716-626-7415",
        "authorized_official_credential": "R.D., CDN"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "005917-1",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.