Individual provider Active NPI

Aderonke F Gbadebo, MD, MPH, MS

  • Pediatrics Physician
  • Saint Louis, MO
National Provider Identifier
1720738743
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2026027323 Issued in MO
Practice address
Wusm Peds, 1 Childrens PL MSC 8116-0043-08
Saint Louis, MO 63110
Phone
(314) 454-4826
Fax
(314) 454-4633
NPI assigned
Mar 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2026027323 MO Primary
Pediatrics Physician 208000000X 79303 MN

Addresses

Primary practice location

Wusm Peds, 1 Childrens PL MSC 8116-0043-08
Saint Louis, MO 63110

Mailing address

Wusm Peds, 1 Childrens PL MSC 8116-0043-08
Saint Louis, MO 63110
Phone (314) 454-4826

Other practice location 1

2450 Riverside Ave
Minneapolis, MN 55454-1450
Phone (612) 624-4477

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250527001496 MN Practitioner - Pediatric Medicine 5092196212 Reassigns benefits to 1 organization
I20250829001937 TX Practitioner - Pediatric Medicine 5092196212 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

40520 County Hwy 34
Ogema, MN 56569

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
79303MNMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services CurrentSince Jun 1, 2025 Accepting new patients
Fairview Health Services CurrentSince Jun 1, 2025 Accepting new patients
Pine Point Health Station CurrentSince Jul 28, 2025 Accepting new patients
Fairview Health Services Current Accepting new patients
White Earth Indian Health Center Current Accepting new patients
Naytahwaush Health Center CurrentSince Jul 28, 2025 Accepting new patients

Locations

2471 310th Ave
#C
Mahnomen, MN 56557
Phone (218) 935-2238

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

40520 County Highway 34
#C
Ogema, MN 56569
Phone (218) 983-4300

40520 County Highway 34
Ogema, MN 56569
Phone (218) 983-4300

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740

Interoperability endpoints

  • Direct secure messaging: agbadebo682095@fairview.direct-ci.com

Organizations & group practices 7

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": "1648080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1720738743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "WUSM PEDS, 1 CHILDRENS PL MSC 8116-0043-08",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63110",
            "telephone_number": "314-454-4826",
            "fax_number": "314-454-4633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WUSM PEDS, 1 CHILDRENS PL MSC 8116-0043-08",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63110",
            "telephone_number": "314-454-4826",
            "fax_number": "314-454-4633"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2450 Riverside Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554541450",
            "country_code": "US",
            "telephone_number": "612-624-4477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GBADEBO",
        "first_name": "ADERONKE",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "MD, MPH, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-24",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2026027323",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "79303",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.