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DR. TEMIDAYO OLUGBENGA ODUGBESAN M.D., SA-C
NPI 1477909448
Student in an Organized Health Care Education/Training Program in Montgomery, AL

Active since May 10, 2016PECOS Enrolled
6117 BOARDWALK BLVD APT J, MONTGOMERY, AL 36117(872) 806-4250 Get Directions Write a Review

NPPES record last updated: June 13, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 13, 2024, Apr 3, 2024, May 10, 2016 (3 updates tracked since 2016).

About Dr. Temidayo Olugbenga Odugbesan M.d., Sa-c NPPES

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

DR. TEMIDAYO OLUGBENGA ODUGBESAN M.D., SA-C (NPI 1477909448) is an individual student in an organized health care education/training program in Montgomery, Alabama and active in the NPI registry since May 2016. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1477909448
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. TEMIDAYO OLUGBENGA ODUGBESANCredential: M.D., SA-C
Location Address6117 BOARDWALK BLVD APT JMontgomery, AL 36117-2812
Mailing Address2024 Chestnut StMontgomery, AL 36106-1111 · (334) 440-3061
Phone(872) 806-4250
Sole ProprietorNo
Enumeration DateMay 10, 2016
Last NPPES UpdateJune 13, 20243 updates tracked since enumeration
NPPES CertifiedJune 13, 2024
✔ NPI 1477909448 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ 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.
Also ListedPhysician Assistant · SurgicalTaxonomy 363AS0400X · License 238.000495 (IL)
6117 BOARDWALK BLVD APT J, Montgomery, AL 36117
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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. Temidayo Olugbenga Odugbesan M.d., Sa-c 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.

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 Temidayo Odugbesan's NPI number?

The NPI number for Temidayo Odugbesan is 1477909448. It was assigned to this individual provider in the NPPES registry on May 10, 2016.

Where is Temidayo Odugbesan located?

Temidayo Odugbesan practices at 6117 Boardwalk Blvd Apt J, Montgomery, AL 36117. The listed phone number is (872) 806-4250.

What is Temidayo Odugbesan's specialty?

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

Is Temidayo Odugbesan enrolled in Medicare?

Yes. Temidayo Odugbesan is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Temidayo Odugbesan was last updated on June 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.