Olamide Odubogun, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

297359 Issued in NY

Practice address

110 S Bedford Rd
Mount Kisco, NY 10549-3446

Phone

(914) 241-1050

NPI assigned

Jun 8, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles (4 of 8)

Locations

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722

Interoperability endpoints

• Direct secure messaging: oodubogun129953@direct.optum.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Optum Medical Care, P.C.

  • Cardiovascular Disease Physician
  • Mount Kisco, NY
  • NPI 1982643003

  NY

  Medicare reassignment NPD
• Optum Medical Care, P.C.

  • Durable Medical Equipment & Medical Supplies
  • New Hyde Park, NY
  • NPI 1053190595
  NPD
• Mount Kisco Medical Group

  • Hematology (Internal Medicine) Physician
  • Fishkill, NY
  • NPI 1952356362
  NPD (past)
• Scarsdale Medical Group LLP

  • Internal Medicine Physician
  • Scarsdale, NY
  • NPI 1578624623
  NPD (past)

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

{
    "created_epoch": "1339113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782172800000",
    "number": "1174885834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 300",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170420300",
            "telephone_number": "717-270-7780",
            "fax_number": "717-274-9746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 S BEDFORD RD",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105493446",
            "telephone_number": "914-241-1050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "618 Cornwall Rd",
            "address_2": "Building 2",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "170427089",
            "country_code": "US",
            "telephone_number": "717-279-6700",
            "fax_number": "717-279-6759",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ODUBOGUN",
        "first_name": "OLAMIDE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-08",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "297359",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie O'Leary, PSY.D.
• Kathryn M O'Loughlin, LMSW
• Larissa O'Loughlin, RN, IBCLC
• Deborah O'Neill
• Sharon Lee O'Neill
• Jin Sub Oh, D.M.D.
• Oare Mary Okoh, MD
• Ashly Oommen
• Open Door Family Medical Center, Inc.
• Open Door Family Medical Center, Inc.

• All providers in Mount Kisco, NY
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.