Adekunle Emmanuel Oluwadare, OD MSC

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

GA2345 Issued in GA

Practice address

1342 Auburn Rd
Dacula, GA 30019-1674

Phone

(770) 237-8150

Fax

(678) 889-9546

NPI assigned

Oct 6, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Pennsylvania College of Optometry, 2005

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Eyewatch Eye Care and Associates LLC

  • Optometrist
  • Buford, GA
  • NPI 1205127925
  Medicare reassignment Authorized official
• Victory Eyecare LLC

  • Optometrist
  • Dacula, GA
  • NPI 1164695045
  Medicare reassignment NPD

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1215925078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3592 HUDDLESTONE LN",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305194652",
            "telephone_number": "610-800-1125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1342 AUBURN RD",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300191674",
            "telephone_number": "770-237-8150",
            "fax_number": "678-889-9546"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1550 Mall Of Georgia Blvd",
            "address_purpose": "LOCATION",
            "city": "Buford",
            "state": "GA",
            "postal_code": "305196551",
            "country_code": "US",
            "telephone_number": "678-288-3024",
            "fax_number": "678-894-4153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLUWADARE",
        "first_name": "ADEKUNLE",
        "middle_name": "EMMANUEL",
        "credential": "OD MSC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-06",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG001715",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "GA",
            "license": "GA2345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE TO PRACTICE OPTOMETRY",
            "identifier": "GA2345",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edward Ochuwa, DBH
• Claire Eden Odakura, OTR/L
• Gloria Oduro, NP
• Peter Ojo
• Anuli Okolo
• Nnenna Elizabeth Onyeukwu, NP
• Opticure-Medix LLC
• Optimal Billing Management
• Optimal Health Services LLC
• Order Medicaid Glasses Online

• Corneal and Contact Management Optometrist in Dacula, GA
• Providers in Dacula, GA by specialty
• Corneal and Contact Management Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.