Individual provider Active NPI

Samuel Adedayo Adeseye, O.D.

  • Optometrist
  • Houston, TX
National Provider Identifier
1750694451
Registry record updated Sep 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7539T Issued in TX
Practice address
2464 Highway 6 S
Houston, TX 77077-5251
Phone
(281) 558-2010
Fax
(281) 558-7099
NPI assigned
Jul 22, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7539T TX Primary

Addresses

Primary practice location

2464 Highway 6 S
Houston, TX 77077-5251

Mailing address

2464 Highway 6 S
Houston, TX 77077-5251
Phone (281) 558-2010

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20130725000081 TX Practitioner - Optometry 5193966745 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7539TXMDBehavioral Analyst
7539TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Bruce Wick OD PHD PA Optometrist CurrentSince Jun 1, 2013 Accepting new patients
Adeseye Eye Care, LLC Optometrist CurrentSince Jun 1, 2015 Accepting new patients

Locations

2464 Highway 6 S
Houston, TX 77077
Phone (281) 558-2010

13615 Bellaire Blvd
Houston, TX 77083
Phone (281) 933-3446

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": "1279756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662076800000",
    "number": "1750694451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2464 HIGHWAY 6 S",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770775251",
            "telephone_number": "281-558-2010",
            "fax_number": "281-558-7099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2464 HIGHWAY 6 S",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770775251",
            "telephone_number": "281-558-2010",
            "fax_number": "281-558-7099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADESEYE",
        "first_name": "SAMUEL",
        "middle_name": "ADEDAYO",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-22",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7539T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.