Taiwo Odukoya Odutola, OWNER - Medicare Nurse Practitioner in Carson, CA

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Taiwo Odukoya Odutola, OWNER is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Carson, California. His current practice location is 21880 Orrick Ave, Carson, California. You can reach out to his office (for appointments etc.) via phone at (310) 927-2119.

Taiwo Odukoya Odutola is licensed to practice in California (license number 95022131) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1467178947.

Contact Information

Taiwo Odukoya Odutola, OWNER
21880 Orrick Ave,
Carson, CA 90745-3052
(310) 927-2119
Not Available

Map and Direction




Provider's Profile

Full NameTaiwo Odukoya Odutola
GenderMale
SpecialityNurse Practitioner - Psychiatric/mental Health
Location21880 Orrick Ave, Carson, California
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1467178947
  • Provider Enumeration Date: 10/17/2022
  • Last Update Date: 12/19/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 2668816596
  • Enrollment ID: I20240220001678

Medical Identifiers

Medical identifiers for Taiwo Odukoya Odutola such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1467178947NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LP0808XNurse Practitioner - Psychiatric/mental Health 95022131 (California)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Taiwo Odukoya Odutola allows following entities to bill medicare on his behalf.
Entity NameWaterside Healthcare Services Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1922876895
PECOS PAC ID: 0840634770
Enrollment ID: O20240220001315

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Taiwo Odukoya Odutola is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Taiwo Odukoya Odutola, OWNER
21880 Orrick Ave,
Carson, CA 90745-3052

Ph: (310) 927-2119		Taiwo Odukoya Odutola, OWNER
21880 Orrick Ave,
Carson, CA 90745-3052

Ph: (310) 927-2119

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

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