Ayotunde Kofoworola Ayodele, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

199147 Issued in CA

Practice address

1920 Memorial Dr
Ceres, CA 95307-1827

Phone

(209) 383-7441

NPI assigned

Nov 9, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC, CA2 enrollments

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 2

Specialty

Pediatric Medicine

Education

Howard University College of Medicine, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aayodele27893@clinicasierravista.direct-ci.com

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.

• Eau Claire Cooperative Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Columbia, SC
  • NPI 1346249430

  Pediatrics, SC

  Medicare reassignment NPD
• Clinica Sierra Vista

  • Federally Qualified Health Center (FQHC)
  • Bakersfield, CA
  • NPI 1861494338

  CA

  Medicare reassignment
• Clinica Sierra Vista

  • Community/Retail Pharmacy
  • Lamont, CA
  • NPI 1275161325
  NPD
• Clinica Sierra Vista

  • Federally Qualified Health Center (FQHC)
  • Arvin, CA
  • NPI 1518969211
  NPD
• Eau Claire Cooperative Health Center ,Inc.

  • Federally Qualified Health Center (FQHC)
  • Columbia, SC
  • NPI 1588375653
  NPD
• Eau Claire Cooperative Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Eastover, SC
  • NPI 1811294978
  NPD
• Clinica Sierra Vista

  • Federally Qualified Health Center (FQHC)
  • Bakersfield, CA
  • NPI 1245234673
  NPD (past)

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1902887706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 S HERLONG AVE",
            "address_2": "SUITE 104",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297329446",
            "telephone_number": "803-980-6610",
            "fax_number": "803-980-6162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 MEMORIAL DR",
            "city": "CERES",
            "state": "CA",
            "postal_code": "953071827",
            "telephone_number": "209-383-7441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2525 Kinard St",
            "address_purpose": "LOCATION",
            "city": "Newberry",
            "state": "SC",
            "postal_code": "291082909",
            "country_code": "US",
            "telephone_number": "803-405-0220",
            "fax_number": "803-405-0222",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "430 S Herlong Ave",
            "address_2": "Suite 104",
            "address_purpose": "LOCATION",
            "city": "Rock Hill",
            "state": "SC",
            "postal_code": "297329446",
            "country_code": "US",
            "telephone_number": "803-980-6610",
            "fax_number": "803-980-6162",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AYODELE",
        "first_name": "AYOTUNDE",
        "middle_name": "KOFOWOROLA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "199147",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "SC",
            "license": "SC 21581",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "21581",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP2934",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yvonne Augustin, LVN
• Jasmeen Aulakh, LVN
• Fanny Raquel Aviles
• Tyler Craig Ayala
• Zehra Ayhan
• James Obaldo Azores
• Bennie Baca, LVN
• Yogitha N Badam, M.D
• Myrna Briones Bagaoisan-Asuncion, RN
• Navneet Kaur Bahia

• All providers in Ceres, CA
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2025; 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.