Dr Ayotunde Kofoworola Ayodele, MD in Ceres, CA

Dr Ayotunde Kofoworola Ayodele, MD is a medicare enrolled "Pediatrics" physician in Ceres, California. His current practice location is 1920 Memorial Dr, Ceres, California. You can reach out to his office (for appointments etc.) via phone at (209) 383-7441.

Dr Ayotunde Kofoworola Ayodele is licensed to practice in California (license number 199147) 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 1902887706.

Contact Information

	Dr Ayotunde Kofoworola Ayodele, MD
	1920 Memorial Dr, Ceres, CA 95307-1827
	(209) 383-7441
	Not Available

Map and Direction

Physician's Profile

Full Name	Dr Ayotunde Kofoworola Ayodele
Gender	Male
Speciality	Pediatrics
Location	1920 Memorial Dr, Ceres, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1902887706
Provider Enumeration Date: 11/09/2005
Last Update Date: 07/14/2025

Medicare PECOS Information:

PECOS PAC ID: 5395268825
Enrollment ID: I20250325004096

Medical Identifiers

Medical identifiers for Dr Ayotunde Kofoworola Ayodele such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1902887706	NPI	-	NPPES
GP2934	Medicaid	SC

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208000000X	Pediatrics	199147 (California)	Primary
174400000X	Specialist	SC 21581 (South Carolina)	Secondary
208000000X	Pediatrics	21581 (South Carolina)	Secondary

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. Dr Ayotunde Kofoworola Ayodele allows following entities to bill medicare on his behalf.

Entity Name	Eau Claire Cooperative Health Center, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1346249430 PECOS PAC ID: 3274434220 Enrollment ID: O20040114000335

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. Dr Ayotunde Kofoworola Ayodele 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 Address	Practice Location Address
Dr Ayotunde Kofoworola Ayodele, MD 430 S Herlong Ave, Suite 104, Rock Hill, SC 29732-9446 Ph: (803) 980-6610	Dr Ayotunde Kofoworola Ayodele, MD 1920 Memorial Dr, Ceres, CA 95307-1827 Ph: (209) 383-7441

Reviews and Comments

Pediatrics Doctors in Ceres, CA

Felix A. Conte, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1920 Memorial Dr, Ceres, CA 95307 Phone: 209-538-1096 Fax: 209-538-1099
Kenneth James, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1920 Memorial Dr, Ceres, CA 95307 Phone: 209-541-3000
Lynette R Grandison, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2516 E Whitmore Ave, Ceres, CA 95307 Phone: 209-538-1733

Dr Ayotunde Kofoworola Ayodele, MD - Medicare Pediatrics in Ceres, CA