Individual provider Active NPI

Olutosin Ojugbele, M.D.

  • Pediatrics Physician
  • Providence, RI
National Provider Identifier
1154741643
Registry record updated Sep 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD17241 Issued in RI
Practice address
593 Eddy St
Providence, RI 02903-4923
Phone
(401) 444-6195
Fax
(401) 444-6378
NPI assigned
Apr 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2020

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 MD17241 RI Primary

Addresses

Primary practice location

593 Eddy St
Providence, RI 02903-4923

Mailing address

117 Ellenfield St Ste 101
Providence, RI 02905-4541
Phone (401) 444-6779

Other names 1

  • Tosin Ojugbele Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20201109001448 RI Practitioner - Pediatric Medicine 1153682588 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD17241RIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Corporation Current Accepting new patients
Rhode Island Hospital CurrentSince Dec 1, 2020 Accepting new patients
Rhode Island Hospital Pediatrics CurrentSince Dec 1, 2020 Accepting new patients
Rhode Island Hospital Past Accepting new patients
Rhode Island Hospital Past Accepting new patients

Locations

593 Eddy St
Ste 9B
Providence, RI 02903
Phone (401) 444-5280

593 Eddy St
Lowr
Providence, RI 02903
Phone (401) 444-4471

593 Eddy St
#921
Providence, RI 02903
Phone (401) 444-3250

593 Eddy St
Ste 5
Providence, RI 02903
Phone (401) 444-3996

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

593 Eddy St
Providence, RI 02903

Interoperability endpoints

  • Direct secure messaging: oojugbele195233@brownhealth.medalliesdirect.net

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1398211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1154741643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 ELLENFIELD ST STE 101",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054541",
            "telephone_number": "401-444-6779",
            "fax_number": "401-444-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-6195",
            "fax_number": "401-444-6378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OJUGBELE",
        "first_name": "OLUTOSIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-23",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "RI",
            "license": "MD17241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TOSIN",
            "last_name": "OJUGBELE",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.