Tiwadayo Cecilia Sam-Odusina, MD

Primary specialty

Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X

License

MD21092 Issued in RI

Practice address

593 Eddy St
Providence, RI 02903-4923

Phone

(401) 444-4471

Fax

(401) 444-7574

NPI assigned

Aug 7, 2020

Last updated

Jun 2, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Pediatric MedicineAlso: Pulmonary Disease

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: fjq9001@direct.nyp.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rhode Island Hospital

  • Pediatrics Physician
  • Providence, RI
  • NPI 1861420333
  NPD (past)
• Rhode Island Hospital

  • General Acute Care Hospital
  • Providence, RI
  • NPI 1972768174
  NPD (past)

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

{
    "created_epoch": "1596758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1235749839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 LA SALLE SQ",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029031814",
            "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": "401-444-4471",
            "fax_number": "401-444-7574"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Dudley St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029052401",
            "country_code": "US",
            "telephone_number": "401-274-1122",
            "fax_number": "401-453-7571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAM-ODUSINA",
        "first_name": "TIWADAYO",
        "middle_name": "CECILIA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-07",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NJ",
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "RI",
            "license": "MD21092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carla Angela Salvadore, APRN
• Salvaggio Therapy, LLC
• Gianella Salvaggio
• Sandra Salzillo-Shields, MHC
• Richard S Salzman, MD
• Vinay Sama, MD
• Fadi Samaan, MD
• Joseph G. Samartano
• Prakash Sampath, MD
• Marie Marguerite Sample, CNM

• Pediatric Pulmonology Physician in Providence, RI
• Providers in Providence, RI by specialty
• Pediatric Pulmonology Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.