NPIMap

Individual provider Active NPI

Adedapo M Oduwole, MD

  • Psychiatry Physician
  • Myrtle Beach, SC
National Provider Identifier
1720139645
Registry record updated Mar 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
31507 Issued in SC
Practice address
1203 48TH Ave N
202
Myrtle Beach, SC 29577-5425
Phone
(843) 449-2576
Fax
(843) 449-6851
NPI assigned
Jan 16, 2007
Last updated
Mar 21, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 43425 WI
Psychiatry Physician 2084P0800X 31507 SC Primary

Addresses

Primary practice location

1203 48TH Ave N
202
Myrtle Beach, SC 29577-5425

Mailing address

1203 48TH Ave N
202
Myrtle Beach, SC 29577-5425
Phone (843) 449-2576

Other names 1

  • Oduwole M Adedaop Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20091110000244 SC Practitioner - PsychiatryPractitioner - Addiction Medicine 2062550114 Reassigns benefits to 1 organization
I20260107002764 NY Practitioner - PsychiatryPractitioner - Internal Medicine 2062550114 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Addiction Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mofdaps and CompanyGroup PAC ID 3678611720, 6 clinicians

Practice addresses (Care Compare)

1203 48TH Ave N
Suite 202
Myrtle Beach, SC 29577-5425
Phone (843) 449-2576

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.29 of 100Reported as apm
Quality
80.38
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mofdaps and Company Psychiatry CurrentSince Aug 6, 2009 Accepting new patients
Multiviz Medical Services PC CurrentSince Jan 1, 2026 Accepting new patients
HHC South Carolina Inc Past Accepting new patients
University Group Medical Associates, P.C Psychiatry Past Accepting new patients

Locations

529 Beach 20th St
Far Rockaway, NY 11691
Phone (516) 770-5712

300 Garden City Plz
Ste 418
Garden City, NY 11530
Phone (516) 481-7050

80 N Franklin St
Hempstead, NY 11550
Phone (516) 481-6433

1203 48th Ave N
Ste 202
Myrtle Beach, SC 29577
Phone (843) 449-2576

Interoperability endpoints

  • Direct secure messaging: aoduwole24946@directmcleodehealth.org

Organizations & group practices 4

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 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395360000000",
    "number": "1720139645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1203 48TH AVE N",
            "address_2": "202",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295775425",
            "telephone_number": "843-449-2576",
            "fax_number": "843-449-6851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 48TH AVE N",
            "address_2": "202",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295775425",
            "telephone_number": "843-449-2576",
            "fax_number": "843-449-6851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODUWOLE",
        "first_name": "ADEDAPO",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2014-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "43425",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "31507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ODUWOLE",
            "last_name": "ADEDAOP",
            "middle_name": "M",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.