Individual provider Active NPI

Richmond Opuye Odele, MBBS

  • Pediatrics Physician
  • Royal Oak, MI
National Provider Identifier
1952141814
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4351052542 Issued in MI
Practice address
3535 W 13 Mile Rd
Royal Oak, MI 48073
Phone
(248) 551-3000
Fax
(248) 551-2032
NPI assigned
May 29, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4351052542 MI Primary

Addresses

Primary practice location

3535 W 13 Mile Rd
Royal Oak, MI 48073

Mailing address

3535 W 13 Mile Rd
Royal Oak, MI 48073
Phone (248) 551-3000

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20251203004025 MI Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 9931692324

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4351052542MIMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1716940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1952141814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 W 13 MILE RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "48073",
            "telephone_number": "248-551-3000",
            "fax_number": "248-551-2032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 W 13 MILE RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "48073",
            "telephone_number": "248-551-3000",
            "fax_number": "248-551-2032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODELE",
        "first_name": "RICHMOND",
        "middle_name": "OPUYE",
        "name_prefix": "Mr.",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-29",
        "last_updated": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4351052542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.