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JESULOLUWA SHODIPO
NPI 1417759614
Student in an Organized Health Care Education/Training Program in Providence, RI

Active since March 26, 2025PECOS Enrolled
593 EDDY ST, PROVIDENCE, RI 02903(401) 793-2695(401) 444-4165 Get Directions Write a Review

NPPES record last updated: July 1, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 2, 2026, Mar 28, 2025 (2 updates tracked since 2025).

About Jesuloluwa Shodipo NPPES

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

JESULOLUWA SHODIPO (NPI 1417759614) is an individual student in an organized health care education/training program in Providence, Rhode Island, licensed in Rhode Island (CLP07088) and active in the NPI registry since March 2025. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1417759614
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameJESULOLUWA SHODIPO
Location Address593 EDDY STProvidence, RI 02903-4923
Mailing Address593 Eddy StProvidence, RI 02903-4923 · (401) 793-2695 · Fax (401) 444-4165
Phone(401) 793-2695
Fax(401) 444-4165
Sole ProprietorNo
Enumeration DateMarch 26, 2025
Last NPPES UpdateJuly 1, 20262 updates tracked since enumeration
NPPES CertifiedJuly 1, 2026
✔ NPI 1417759614 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in RI · CLP07088
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
593 EDDY ST, Providence, RI 02903
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jesuloluwa Shodipo is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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. 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 Jesuloluwa Shodipo's NPI number?

The NPI number for Jesuloluwa Shodipo is 1417759614. It was assigned to this individual provider in the NPPES registry on March 26, 2025.

Where is Jesuloluwa Shodipo located?

Jesuloluwa Shodipo practices at 593 Eddy St, Providence, RI 02903. The listed phone number is (401) 793-2695.

What is Jesuloluwa Shodipo's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Jesuloluwa Shodipo enrolled in Medicare?

Yes. Jesuloluwa Shodipo is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jesuloluwa Shodipo was last updated on July 1, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.