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OLUSEGUN OBAFEMI OWOTOMO MD
NPI 1184184608
Pediatrics - Pediatric Pulmonology in Saint Louis, MO

Active since March 21, 2019PECOS Enrolled
1465 S GRAND BLVD, SAINT LOUIS, MO 63104(314) 268-6439(314) 268-2798 Get Directions Write a Review

NPPES record last updated: August 26, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 16, 2022, Mar 21, 2019 (2 updates tracked since 2019).

About Olusegun Obafemi Owotomo Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OLUSEGUN OBAFEMI OWOTOMO MD (NPI 1184184608) is an individual pediatric pulmonology provider in Saint Louis, Missouri, licensed in Missouri (2025031593) and active in the NPI registry since March 2019. He is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1184184608
Entity TypeIndividualMale
Primary Taxonomy2080P0214X
Provider Legal NameOLUSEGUN OBAFEMI OWOTOMOCredential: MD
Location Address1465 S GRAND BLVDSaint Louis, MO 63104-1003
Mailing Address1465 S Grand BlvdSaint Louis, MO 63104-1003 · (314) 268-6439 · Fax (314) 268-2798
Phone(314) 268-6439
Fax(314) 268-2798
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateMarch 21, 2019
Last NPPES UpdateAugust 26, 20252 updates tracked since enumeration
NPPES CertifiedAugust 26, 2025
✔ NPI 1184184608 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric PulmonologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0214X
License✔ Licensed in MO · 2025031593
Definition
A pediatrician dedicated to the prevention and treatment of all respiratory diseases affecting infants, children and young adults. This specialist is knowledgeable about the growth and development of the lung, assessment of respiratory function in infants and children, and experienced in a variety of invasive and noninvasive diagnostic techniques.
Also ListedPediatricsTaxonomy 208000000X · License D0093346 (MD)
1465 S GRAND BLVD, Saint Louis, MO 63104
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Olusegun Obafemi Owotomo Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5799129888
PECOS Enrollment IDI20250813001101
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. SARAH MARGARET HANLY PH.D.
Psychologist (Clinical)
1465 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 577-5667
KAVIPRIYA KOMESWARAN
Pediatrics (Pediatric Critical Care Medicine)
1465 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 617-2000
ALEXIS HAAS STEWART
Anesthesiologist Assistant
1465 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 977-5700
NATALIE DRURY RD, LD
Dietitian, Registered (Nutrition, Pediatric)
1465 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 577-5387
TIMOTHY J KUTZ MD
Pediatrics (Child Abuse Pediatrics)
1465 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 268-6406
CHRISTOPHER SALLEE MD
Pediatrics
1465 S GRAND BLVD
ST. LOUIS, MO 63104
St. Louis City (314) 577-1607
AMBER GRANA DO
Pediatrics (Pediatric Critical Care Medicine)
1465 S GRAND BLVD, DIVISION OF PEDIATRIC CRITICAL CARE
SAINT LOUIS, MO 63104
St. Louis City (314) 577-5695
DR. ETHAN EMIL PFEIFER MD
Student in an Organized Health Care Education/Training Program
1465 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 268-4070

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Olusegun Owotomo's NPI number?

The NPI number for Olusegun Owotomo is 1184184608. It was assigned to this individual provider in the NPPES registry on March 21, 2019.

Where is Olusegun Owotomo located?

Olusegun Owotomo practices at 1465 S Grand Blvd, Saint Louis, MO 63104. The listed phone number is (314) 268-6439.

What is Olusegun Owotomo's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Pulmonology, with taxonomy code 2080P0214X.

Is Olusegun Owotomo enrolled in Medicare?

Yes. Olusegun Owotomo is registered in the Medicare PECOS enrollment system.

What insurance does Olusegun Owotomo accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health and Ambetter from Sunflower Health Plan and 3 other insurers list Olusegun Owotomo as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Olusegun Owotomo was last updated on August 26, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.