Individual provider Active NPI

Adedayo Oduwole

  • Diagnostic Radiology Physician
  • Philadelphia, PA
National Provider Identifier
1417419144
Registry record updated Feb 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
317134 Issued in NY
Practice address
3400 Civic Center Blvd
Philadelphia, PA 19104-5127
Phone
(215) 662-3264
NPI assigned
Apr 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NY
Diagnostic Radiology Physician 2085R0202X 317134 NY Primary
Diagnostic Radiology Physician 2085R0202X MD484619 PA

Addresses

Primary practice location

3400 Civic Center Blvd
Philadelphia, PA 19104-5127

Mailing address

3400 Civic Center Blvd
Philadelphia, PA 19104-5127

Other practice location 1

5501 Old York Rd
Philadelphia, PA 19141-3018
Phone (215) 456-7000

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20260120002346 PA Practitioner - Diagnostic Radiology 9133458938 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Medical College of Georgia School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Einstein Practice Plan IncGroup PAC ID 2769395896, 774 clinicians

Practice addresses (Care Compare)

4900 Frankford Ave
Suite 2
Philadelphia, PA 19124-2618
Phone (215) 831-2000

50 E Township Line Rd
Medical Arts BLDG 2ND Floor
Elkins Park, PA 19027-2220
Phone (215) 663-6067

5501 Old York Rd
Phila, PA 19141-3018

5501 Old York Rd Levy 2
Einstein Pediatrics Associates
Philadelphia, PA 19141-3018
Phone (215) 456-6786

5501 Old York Rd WCB 4TH FLR
Einstein CT Surgery Assoc
Philadelphia, PA 19141-3018
Phone (215) 456-8270

559 W Germantown Pike
East Norriton, PA 19403-4250

60 E Township Line Rd
Elkins Park, PA 19027-2220

60 E Townshipline Rd
Elkins Park, PA 19027-2220

609 W Germantown Pike
East Norriton, PA 19403-4250

676 Dekalb Pike
Blue Bell, PA 19422-1223

9880 Bustleton Ave
Philadelphia, PA 19115-2185
Phone (215) 456-8242

Einstein Surgical Assocs
700 West Germantown Pike
East Norriton, PA 19403-4250
Phone (484) 622-7800

Medical Arts Building G-01
Einstein Endocrinology Associates
Elkins Park, PA 19027-2220
Phone (215) 572-5200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
317134NYMDDiagnostic Radiology Physician
MD484619PAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Einstein Practice Plan Inc CurrentSince Dec 14, 2025 Accepting new patients
Einstein Practice Plan Inc CurrentSince Dec 14, 2025 Accepting new patients

Locations

5501 Old York Rd
Ste 3
Philadelphia, PA 19141
Phone (215) 456-7180

5501 York Rd
Philadelphia, PA 19141
Phone (215) 456-7405

Organizations & group practices 3

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770681600000",
    "number": "1417419144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045127",
            "telephone_number": "215-662-3264"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5501 Old York Rd",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191413018",
            "country_code": "US",
            "telephone_number": "215-456-7000",
            "fax_number": "215-456-5926",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ODUWOLE",
        "first_name": "ADEDAYO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-02",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "317134",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD484619",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.