Kayode Odutayo, M.D

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

296259 Issued in NY

Practice address

1650 Grand Concourse
Bronx, NY 10457-7679

Phone

(718) 992-7669

NPI assigned

Aug 13, 2013

Last updated

Jul 17, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Internal Medicine

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southwest Suffolk Medical PCGroup PAC ID 0244396349, 204 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Good Samaritan Hospital Medical Center Hospital, West Islip, NY, CCN 330286

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: kodutayo788014@direct.trinity-health.org

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.

• Southwest Suffolk Medical, P.C.

  • Surgical Oncology Physician
  • Smithtown, NY
  • NPI 1104096049
  Medicare reassignment Care Compare group NPD
• Bronxcare Health System

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1245390855
  Medicare reassignment NPD
• Lawrence Medical Associates, PC

  dba NewYork-Presbyterian Medical Group/Westchester

  • Internal Medicine Physician
  • Yorktown Heights, NY
  • NPI 1023257441
  Medicare reassignment NPD
• MVHS Inc

  dba Mohawk Valley Health System Inc

  • Family Medicine Physician
  • Utica, NY
  • NPI 1770690737
  Medicare reassignment NPD
• North Shore-Lij Medical PC

  dba NHPP Cardiology at Great Neck

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572

  Internal Medicine

  Medicare reassignment NPD
• Samaritan Hospital of Troy, New York

  • General Acute Care Hospital
  • Troy, NY
  • NPI 1043267727

  Internal Medicine

  Medicare reassignment NPD
• St. Peter's Hospital of the City of Albany

  dba St. Peter's Hospital

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1518042357

  Internal Medicine

  Medicare reassignment NPD
• Kayode Odutayo MD PLLC

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1427805746
  Authorized official Same address or phone
• Bronxcare Health System

  • Methadone Clinic
  • Bronx, NY
  • NPI 1801428222
  NPD
• Lawrence Medical Associates, PC

  dba Newyork-Presbyterian Medical Group/Westchester

  • Multi-Specialty Clinic/Center
  • Yorktown Heights, NY
  • NPI 1184115479
  NPD
• Lawrence Medical Associates, PC

  dba NewYork-Presbyterian Medical Group/Westchester ED

  • Emergency Medicine Physician
  • Bronxville, NY
  • NPI 1497260806
  NPD
• MVHS Inc

  dba Mohawk Valley Health System Inc

  • Community/Retail Pharmacy
  • Utica, NY
  • NPI 1306573753
  NPD

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

• Good Samaritan Hospital Medical Center

  • General Acute Care Hospital
  • West Islip, NY
  • NPI 1902865355
  Care Compare affiliation

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

{
    "created_epoch": "1376352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1790118875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 MOTOR PKWY STE 4012324",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117885145",
            "telephone_number": "631-209-5369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104577679",
            "telephone_number": "718-992-7669"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Pelham Pkwy S",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104611003",
            "country_code": "US",
            "telephone_number": "631-209-5369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ODUTAYO",
        "first_name": "KAYODE",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-13",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "296259",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "296259",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "315 S Manning Blvd",
            "city": "Albany",
            "state": "NY",
            "country_code": "US",
            "postal_code": "122081707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Olateju Odumosu, FNP-BC, NP-C
• Olufemi O Odumosu, NURSE ANESTHETIST
• Esther Odunsi
• Edward Oduro-Kwakye, PA, MPH
• Anna Oduro, M.D.
• Odyssey House, Inc
• Odyssey House, Inc.
• Luca Oechslin, MD
• Victor Oelbaum, D.D.S.
• Grace Oettinger, OTR

• Internal Medicine Physician in Bronx, NY
• Providers in Bronx, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.