Individual provider Active NPI

Abolade Oduyemi, OD

  • Optometrist
  • White Plains, NY
National Provider Identifier
1588306641
Registry record updated Feb 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
009782 Issued in NY
Practice address
1133 Westchester Ave Ste 4
White Plains, NY 10604-3516
Phone
(917) 702-6045
NPI assigned
Apr 10, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3904 MN
Optometrist 152W00000X 114003 IA
Optometrist 152W00000X 3385 CT
Optometrist 152W00000X 3745 WI
Optometrist 152W00000X 009782 NY Primary

Addresses

Primary practice location

1133 Westchester Ave Ste 4
White Plains, NY 10604-3516

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

Other practice location 1

1765 Central Park Ave
Yonkers, NY 10710-2828
Phone (914) 961-1004

Other practice location 2

1375 Kings Hwy Ste 300
Fairfield, CT 06824-5396
Phone (917) 702-6045

Other practice location 3

1836 South Ave
LA Crosse, WI 54601-5429
Phone (608) 782-7300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240115001563 NY Practitioner - Optometry 4688058373 Reassigns benefits to 1 organization
I20240425002610 MN Practitioner - Optometry 4688058373 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
200 West Optics LLCGroup PAC ID 5395144380, 38 clinicians

Practice addresses (Care Compare)

1765 Central Park Ave
Yonkers, NY 10710-2828
Phone (914) 961-1004

770 McLean Ave
Yonkers, NY 10704-3876
Phone (914) 803-0500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009782NYMDCounseling Psychologist
3385CTMDOptometrist
3745WIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Brokea Inc. Optometrist CurrentSince Jan 27, 2024 Accepting new patients
Eye Studio Optometrist Past Accepting new patients

Locations

13195 Weaver Lake Rd
Maple Grove, MN 55369
Phone (763) 420-5112

Interoperability endpoints

  • Direct secure messaging: aoduyemi656254@direct.gundersenhealth.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1649548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771891200000",
    "number": "1588306641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 WESTCHESTER AVE STE 4",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106043516",
            "telephone_number": "917-702-6045"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1765 Central Park Ave",
            "address_purpose": "LOCATION",
            "city": "Yonkers",
            "state": "NY",
            "postal_code": "107102828",
            "country_code": "US",
            "telephone_number": "914-961-1004",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1375 Kings Hwy Ste 300",
            "address_purpose": "LOCATION",
            "city": "Fairfield",
            "state": "CT",
            "postal_code": "068245396",
            "country_code": "US",
            "telephone_number": "917-702-6045",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1836 South Ave",
            "address_purpose": "LOCATION",
            "city": "LA Crosse",
            "state": "WI",
            "postal_code": "546015429",
            "country_code": "US",
            "telephone_number": "608-782-7300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ODUYEMI",
        "first_name": "ABOLADE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-10",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3904",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "114003",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "3385",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3745",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "009782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

Verify at the official NPI Registry.