MR. ADEWALE ANTHONY ODERINDE (NP) – Nurse Practitioner, NPI 1376092247

MR. ADEWALE ANTHONY ODERINDE (NP) is a healthcare provider. based in Bonaire, Georgia. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. RN184424 (GA). The NPI Number for MR. ADEWALE ANTHONY ODERINDE (NP) is 1376092247

Main info

Male
11 Years Of Experience
Accepts Medicare Assignment
Name
MR. ADEWALE ANTHONY ODERINDE (NP)
NPI
1376092247
Phone
(478) 284-6452
Address
503 BLUE BONNET TRL
Enumeration Date
3 October 2016
Last Update Date
3 October 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4786331000
Graduation Year
2015 (11 years ago)
PAC ID
3476837246
Group Practice PAC ID
5991004608
Professional Enrollment ID
I20170223001356
Address ID
GA312012102MA777XXSTXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:9State licenses:1Digital endpointsOther names

9,658 NURSE PRACTITIONER in GA

Provider Addresses for MR. ADEWALE ANTHONY ODERINDE (NP)

  • 503 BLUE BONNET TRL

    BONAIRE, GA 310053759

    Phone: (478) 284-6452

    Fax: (478) 225-6609

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $18.

Total Amount is formed as General ($18) + Research ($0) + Ownership ($0) = $18.

Last reported payment date: 2023-07-13 • Largest payer in this snapshot: BTG International, Inc. ($18).

Total Amount

$18

General + Research + Ownership

Payments

1

Total payment records

General Amount

$18

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-07-13

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
BTG International, Inc.$18
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2017-02-23

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20170223001356INurse PractitionerGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99284Emergency department visit with moderate level of medical decision making7148$0
99283Emergency department visit with low level of medical decision making2313$0
99285Emergency department visit with high level of medical decision making1514$0
View full utilization report →

Insurance plans in this area (ZIP 31005)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5991004608View full group profile
NameSpecialtyState
Nurse PractitionerGA
Emergency MedicineSC
Emergency MedicineSC
Emergency MedicineCA
Emergency MedicineGA
Emergency MedicineGA
Pediatric MedicineNC
Pediatric MedicineGA
Emergency MedicineGA
Emergency MedicineGA

Reviews

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Frequently asked questions

What is the 10-digit NPI for MR. ADEWALE ANTHONY ODERINDE (NP)?
MR. ADEWALE ANTHONY ODERINDE (NP) — NPI 1376092247 — is the standard way to identify this listing.
Does the file indicate MR. ADEWALE ANTHONY ODERINDE (NP) is practicing under active NPI?
Directory data currently reports MR. ADEWALE ANTHONY ODERINDE (NP) as active.
What is MR. ADEWALE ANTHONY ODERINDE (NP)'s specialty?
The listing groups MR. ADEWALE ANTHONY ODERINDE (NP) with Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What area does MR. ADEWALE ANTHONY ODERINDE (NP) serve?
MR. ADEWALE ANTHONY ODERINDE (NP)'s listing highlights Bonaire, Georgia; more addresses can appear in NPPES.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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