Active NPI
Adedotun Olutoyin Adewale, MD
- Pediatric Critical Care Medicine Physician
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Critical Care Medicine Physician
- License
- 2022017545
- Practice address
- 1 Childrens PL
Div Ped Critical Care Med
Saint Louis, MO 63110-1002 - Phone
- (314) 454-2527
- Fax
- (314) 747-8880
- NPI assigned
- Feb 10, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 2022017545 | MO | |
| Pediatric Critical Care Medicine Physician | 2080P0203X | 2022017545 | MO | Primary |
Addresses
Primary practice location
1 Childrens PL
Div Ped Critical Care Med
Saint Louis, MO 63110-1002
Mailing address
PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 454-2527
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200110809 | Medicaid | MO |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Washington University |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI, MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210730002815 | WI | Practitioner - Critical Care (Intensivists) | 5092062653 | Reassigns benefits to 1 organization |
| I20230126000672 | MO | Practitioner - Pediatric Medicine | 5092062653 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Washington University
Practice addresses (Care Compare)
1 Childrens PL
Saint Louis, MO 63110-1002
Phone (314) 273-1006
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Washington University | Current | Accepting new patients | |
| The Medical College of Wisconsin, Inc. | Current | Accepting new patients | |
| Washington University | Current | Accepting new patients |
Locations
1 Childrens Pl
Ste C
Saint Louis, MO 63110
Phone (314) 454-2104
1 Childrens Pl
Saint Louis, MO 63110
Phone (314) 454-2076
1234 S Kingshighway Blvd
Ste 1200
Saint Louis, MO 63110
8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100
9000 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 266-2625
Interoperability endpoints
- aadewale515038@direct.franciscanalliance.org
Organizations & group practices 3
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.
-
- Multi-Specialty Clinic/Center
- Saint Louis, MO
- NPI 1962442475
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1423526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744675200000",
"number": "1457742546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7412011",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606742011",
"telephone_number": "314-454-2527",
"fax_number": "314-747-8880"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 CHILDRENS PL",
"address_2": "DIV PED CRITICAL CARE MED",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631101002",
"telephone_number": "314-454-2527",
"fax_number": "314-747-8880"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADEWALE",
"first_name": "ADEDOTUN",
"middle_name": "OLUTOYIN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-02-10",
"last_updated": "2025-04-15",
"certification_date": "2021-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "2022017545",
"primary": false
},
{
"code": "2080P0203X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Critical Care Medicine",
"state": "MO",
"license": "2022017545",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200110809",
"state": "MO"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "Y",
"affiliationName": "Washington University",
"address_1": "1 Childrens Pl",
"address_2": "Div Ped Critical Care Med",
"city": "Saint Louis",
"state": "MO",
"country_code": "US",
"postal_code": "631101002",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2025; 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.