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DR. DAMILOLA JAKUB AGBOLUAJE MBBS
NPI 1457233256
Student in an Organized Health Care Education/Training Program in St Louis Park, MN

Active since July 23, 2025PECOS Enrolled
6500 EXCELSIOR BLVD, ST LOUIS PARK, MN 55426(952) 993-5000 Get Directions Write a Review

NPPES record last updated: July 23, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Damilola Jakub Agboluaje Mbbs NPPES

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

DR. DAMILOLA JAKUB AGBOLUAJE MBBS (NPI 1457233256) is an individual student in an organized health care education/training program in St Louis Park, Minnesota and active in the NPI registry since July 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1457233256
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. DAMILOLA JAKUB AGBOLUAJECredential: MBBS
Location Address6500 EXCELSIOR BLVDSt Louis Park, MN 55426-4702
Mailing Address6500 Excelsior BlvdSt Louis Park, MN 55426-4702 · (952) 993-5000
Phone(952) 993-5000
Sole ProprietorNo
Enumeration DateJuly 23, 2025
NPPES CertifiedJuly 23, 2025
✔ NPI 1457233256 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
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.
6500 EXCELSIOR BLVD, St Louis Park, MN 55426
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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)

Dr. Damilola Jakub Agboluaje Mbbs 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.

NANCY COLE NELSON M.D.
Obstetrics & Gynecology
6500 EXCELSIOR BLVD
ST LOUIS PARK, MN 55426
Hennepin County (952) 993-3282
DR. KATIE LYNN ANDRINAS MD, MPH
Obstetrics & Gynecology
6500 EXCELSIOR BLVD
ST LOUIS PARK, MN 55426
Hennepin County (952) 993-3282
CARA HOULE MD
Internal Medicine
6500 EXCELSIOR BLVD
ST LOUIS PARK, MN 55426
Hennepin County (952) 993-5000
JANET GRAYSON MD
Internal Medicine
6500 EXCELSIOR BLVD
ST LOUIS PARK, MN 55426
Hennepin County (952) 993-6600
JEFFREY J SHULTZ
Internal Medicine (Cardiovascular Disease)
6500 EXCELSIOR BLVD, PARK NICOLLET CLINIC - HEART & VASCULAR CENTER
ST LOUIS PARK, MN 55426
Hennepin County (952) 993-3246
MARY BETH JOHNSON OTR/L
Occupational Therapist
6500 EXCELSIOR BLVD
ST LOUIS PARK, MN 55426
Hennepin County (952) 993-6087
MARY KATHERINE KOSANDA P.T.
Physical Therapist
6500 EXCELSIOR BLVD
ST LOUIS PARK, MN 55426
Hennepin County (952) 993-6014
JENNIFER A DEUTZ P.T.
Physical Therapist
6500 EXCELSIOR BLVD
ST LOUIS PARK, MN 55426
Hennepin County (952) 993-5900

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 Damilola Agboluaje's NPI number?

The NPI number for Damilola Agboluaje is 1457233256. It was assigned to this individual provider in the NPPES registry on July 23, 2025.

Where is Damilola Agboluaje located?

Damilola Agboluaje practices at 6500 Excelsior Blvd, St Louis Park, MN 55426. The listed phone number is (952) 993-5000.

What is Damilola Agboluaje's specialty?

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

Is Damilola Agboluaje enrolled in Medicare?

Yes. Damilola Agboluaje is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Damilola Agboluaje was last updated on July 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.