Organization Active NPI

Osamede Odiase OD Inc

  • Optometrist
  • Chico, CA
National Provider Identifier
1629844055
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
OSAMEDE ODIASE OD INC
Practice address
2840 Cohasset Rd
Chico, CA 95973-0909
Phone
(530) 899-8175
Fax
(530) 899-8176
NPI assigned
Nov 27, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Authorized official

Name
Osamede S Odiase, ODNPI 1891983219
Title
Owner
Phone
(916) 838-7393

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

2840 Cohasset Rd
Chico, CA 95973-0909

Mailing address

2840 Cohasset Rd
Chico, CA 95973-0909
Phone (530) 899-8175

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240703002407 CA Part B Supplier - Clinic/Group Practice 6901340777 Receives reassigned benefits from 1 practitioner
Practice locations: Chico, CA

National Provider Directory

National Provider Directory

Locations

2840 Cohasset Rd
Cohasset, CA 95973
Phone (530) 899-8175

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1701043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718150400000",
    "number": "1629844055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2840 COHASSET RD",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959730909",
            "telephone_number": "530-899-8175",
            "fax_number": "530-899-8176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2840 COHASSET RD",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959730909",
            "telephone_number": "530-899-8175",
            "fax_number": "530-899-8176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OSAMEDE ODIASE OD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-27",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A",
        "authorized_official_last_name": "ODIASE",
        "authorized_official_first_name": "OSAMEDE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-838-7393",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chico, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; 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.