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DR. KELLON OLUSOLA MD
NPI 1801517313
Student in an Organized Health Care Education/Training Program in Newburgh, NY

Active since September 05, 2022PECOS Enrolled
70 DUBOIS ST, NEWBURGH, NY 12550(845) 561-4400(845) 568-2614 Get Directions Write a Review

NPPES record last updated: September 5, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Kellon Olusola Md NPPES

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

DR. KELLON OLUSOLA MD (NPI 1801517313) is an individual student in an organized health care education/training program in Newburgh, New York and active in the NPI registry since September 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1801517313
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. KELLON OLUSOLACredential: MD
Location Address70 DUBOIS STNewburgh, NY 12550-4851
Mailing Address70 Dubois StNewburgh, NY 12550-4851 · (845) 561-4400 · Fax (845) 568-2614
Phone(845) 561-4400
Fax(845) 568-2614
Sole ProprietorNo
Enumeration DateSeptember 5, 2022
NPPES CertifiedSeptember 4, 2022
✔ NPI 1801517313 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.
70 DUBOIS ST, Newburgh, NY 12550
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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. Kellon Olusola Md 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.

ST. LUKE'S CORNWALL HOSPITAL
General Acute Care Hospital
70 DUBOIS ST
NEWBURGH, NY 12550
Orange County (845) 561-4400
ST. LUKE'S CORNWALL HOSPITAL
Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)
70 DUBOIS ST
NEWBURGH, NY 12550
Orange County (845) 561-4400
JAMES BERSIG MD
Anesthesiology
70 DUBOIS ST, ST LUKES HOSPITAL
NEWBURGH, NY 12550
Orange County (845) 568-2269
HOSPITAL ATTENDING PHYSICIANS
Internal Medicine
70 DUBOIS ST
NEWBURGH, NY 12550
Orange County (845) 561-4400
DR. JARRETT SCOTT LEFBERG D.O.
Emergency Medicine
70 DUBOIS ST
NEWBURGH, NY 12550
Orange County (845) 561-4400
ROBERT BENTIVEGNA MD
Anesthesiology
70 DUBOIS ST
NEWBURGH, NY 12550
Orange County (845) 561-4400
DR. SINDHU SANDESH MD
Anesthesiology
70 DUBOIS ST, ST. LUKES HOSPITAL
NEWBURGH, NY 12550
Orange County (845) 561-4400
SOYOUNG AHN MD
Student in an Organized Health Care Education/Training Program
70 DUBOIS ST
NEWBURGH, NY 12550
Orange County (845) 561-4400

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 Kellon Olusola's NPI number?

The NPI number for Kellon Olusola is 1801517313. It was assigned to this individual provider in the NPPES registry on September 5, 2022.

Where is Kellon Olusola located?

Kellon Olusola practices at 70 Dubois St, Newburgh, NY 12550. The listed phone number is (845) 561-4400.

What is Kellon Olusola's specialty?

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

Is Kellon Olusola enrolled in Medicare?

Yes. Kellon Olusola is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kellon Olusola was last updated on September 5, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.