TIWADAYO CECILIA SAM-ODUSINA MD
NPI 1235749839
Pediatrics - Pediatric Pulmonology in Providence, RI

Q: What is Tiwadayo Sam-odusina's NPI number?

The NPI number for Tiwadayo Sam-odusina is 1235749839. It was assigned to this individual provider in the NPPES registry on August 7, 2020.

Q: What is Tiwadayo Sam-odusina's specialty?

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

Active since August 07, 2020PECOS Enrolled

593 EDDY ST, PROVIDENCE, RI 02903(401) 444-4471(401) 444-7574 Get Directions Write a Review

NPPES record last updated: June 2, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Jun 2, 2026, May 4, 2026, Aug 7, 2020 (3 updates tracked since 2020).

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About Tiwadayo Cecilia Sam-odusina Md NPPES

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

TIWADAYO CECILIA SAM-ODUSINA MD (NPI 1235749839) is an individual pediatric pulmonology provider in Providence, Rhode Island, licensed in Rhode Island (MD21092) and active in the NPI registry since August 2020. She is enrolled in Medicare PECOS, maintains a secondary practice location in Providence, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1235749839

Entity TypeIndividualFemale

Primary Taxonomy2080P0214X

Provider Legal NameTIWADAYO CECILIA SAM-ODUSINACredential: MD

Location Address593 EDDY STProvidence, RI 02903-4923

Mailing Address15 La Salle SqProvidence, RI 02903-1814 · (401) 444-6779 · Fax (401) 444-6912

Phone(401) 444-4471

Fax(401) 444-7574

Sole ProprietorYes

Medical School CMSOtherGraduated 2019

Enumeration DateAugust 7, 2020

Last NPPES UpdateJune 2, 20263 updates tracked since enumeration

NPPES CertifiedJune 2, 2026

✔ NPI 1235749839 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 RI · MD21092

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 ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

593 EDDY ST, Providence, RI 02903

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Secondary Practice Location 1

Location 1101 Dudley StProvidence, RI 02905-2401 · Phone (401) 274-1122 · Fax (401) 453-7571

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tiwadayo Cecilia Sam-odusina Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8527530419

PECOS Enrollment IDI20260611001429

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.

Medicare Billing Reassignments

Medicare enrollment records show Tiwadayo Sam-odusina reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Rhode Island Hospital

Same address

Pediatrics

593 EDDY ST
Providence, RI 02903

Reassigned Medicare billing, Rhode Island enrollment
265 clinicians in this Medicare group

NPI 1861420333 (401) 444-6195

Affinity Physicians LLC

0.2 mi

Anesthesiology

101 DUDLEY STREET, WIH DEPT OF ANESTHESIOLOGY
Providence, RI 02905

Reassigned Medicare billing, Rhode Island enrollment
984 clinicians in this Medicare group

NPI 1053038471 (401) 274-1122

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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. KEITH-AUSTIN SCARFO D.O.

Anesthesiology

593 EDDY ST, APC 6
PROVIDENCE, RI 02903

Providence County (401) 444-3777

AILEEN HSUEH

Surgery

593 EDDY ST
PROVIDENCE, RI 02903

Providence County (401) 444-8450

RHODE ISLAND HOSPITAL

General Acute Care Hospital

593 EDDY ST, MAIN 4
PROVIDENCE, RI 02903

Providence County (401) 444-7585

DR. GA HIE NAM M.D.

Pathology (Anatomic Pathology & Clinical Pathology)

593 EDDY ST
PROVIDENCE, RI 02903

Providence County (401) 444-5057

EUGENIE ATALLAH

Psychiatry & Neurology (Neurology)

593 EDDY ST
PROVIDENCE, RI 02903

Providence County (401) 606-2645

BRET CAULFIELD

Physician Assistant

593 EDDY ST
PROVIDENCE, RI 02903

Providence County (401) 444-4000

JUNG HO GONG

Student in an Organized Health Care Education/Training Program

593 EDDY ST
PROVIDENCE, RI 02903

Providence County (401) 793-2695

FANNY HUANG MD

Student in an Organized Health Care Education/Training Program

593 EDDY ST
PROVIDENCE, RI 02903

Providence County (401) 444-4741

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 Tiwadayo Sam-odusina's NPI number?

The NPI number for Tiwadayo Sam-odusina is 1235749839. It was assigned to this individual provider in the NPPES registry on August 7, 2020.

Where is Tiwadayo Sam-odusina located?

Tiwadayo Sam-odusina practices at 593 Eddy St, Providence, RI 02903. The listed phone number is (401) 444-4471.

What is Tiwadayo Sam-odusina's specialty?

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

Is Tiwadayo Sam-odusina enrolled in Medicare?

Yes. Tiwadayo Sam-odusina is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Tiwadayo Sam-odusina's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Tiwadayo Sam-odusina reassigns Medicare benefits to 2 organizations: Rhode Island Hospital (Providence, RI) and Affinity Physicians LLC (Providence, RI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Tiwadayo Sam-odusina's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Tiwadayo Sam-odusina was last updated on June 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.