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KOLADE DANIEL ODETOYINBO MD
NPI 1871161927
Student in an Organized Health Care Education/Training Program in Portland, OR

Active since June 15, 2021PECOS Enrolled
3181 SW SAM JACKSON PARK RD # L-579, PORTLAND, OR 97239(503) 494-8211 Get Directions Write a Review

NPPES record last updated: June 15, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kolade Daniel Odetoyinbo Md NPPES

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

KOLADE DANIEL ODETOYINBO MD (NPI 1871161927) is an individual student in an organized health care education/training program in Portland, Oregon and active in the NPI registry since June 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1871161927
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameKOLADE DANIEL ODETOYINBOCredential: MD
Location Address3181 SW SAM JACKSON PARK RD # L-579Portland, OR 97239-3098
Mailing Address3181 Sw Sam Jackson Park Rd # L-579Portland, OR 97239-3098 · (503) 494-8211
Phone(503) 494-8211
Sole ProprietorNo
Enumeration DateJune 15, 2021
NPPES CertifiedJune 15, 2021
✔ NPI 1871161927 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.
3181 SW SAM JACKSON PARK RD # L-579, Portland, OR 97239
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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)

Kolade Daniel Odetoyinbo 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.

DR. CLAIRE MCCORD CONRAD MD
Pediatrics
3181 SW SAM JACKSON PARK RD # L-579
PORTLAND, OR 97239
Multnomah County (503) 494-8211
LYNDSEY SANDOW MD
Student in an Organized Health Care Education/Training Program
3181 SW SAM JACKSON PARK RD # L-579
PORTLAND, OR 97239
Multnomah County (503) 494-8311
MS. ERIKA BENNETT MD
Student in an Organized Health Care Education/Training Program
3181 SW SAM JACKSON PARK RD # L-579
PORTLAND, OR 97239
Multnomah County (503) 494-8211
DR. WILLIAM ANDREW FRIZZELL M.D.
Student in an Organized Health Care Education/Training Program
3181 SW SAM JACKSON PARK RD # L-579
PORTLAND, OR 97239
Multnomah County (503) 494-8211
DR. ZOE ANN THUESMUNN MD
Student in an Organized Health Care Education/Training Program
3181 SW SAM JACKSON PARK RD # L-579
PORTLAND, OR 97239
Multnomah County (503) 494-8652
DR. BOONE ARTHUR RHINEHART DO
Pediatrics
3181 SW SAM JACKSON PARK RD # L-579
PORTLAND, OR 97239
Multnomah County (503) 346-0640
BRET GILBERT
Student in an Organized Health Care Education/Training Program
3181 SW SAM JACKSON PARK RD # L-579
PORTLAND, OR 97239
Multnomah County (503) 494-8211
DR. PHILIP JAMES BLATT MD
Student in an Organized Health Care Education/Training Program
3181 SW SAM JACKSON PARK RD # L-579
PORTLAND, OR 97239
Multnomah County (503) 494-8211

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 Kolade Odetoyinbo's NPI number?

The NPI number for Kolade Odetoyinbo is 1871161927. It was assigned to this individual provider in the NPPES registry on June 15, 2021.

Where is Kolade Odetoyinbo located?

Kolade Odetoyinbo practices at 3181 SW Sam Jackson Park Rd # L-579, Portland, OR 97239. The listed phone number is (503) 494-8211.

What is Kolade Odetoyinbo's specialty?

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

Is Kolade Odetoyinbo enrolled in Medicare?

Yes. Kolade Odetoyinbo is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kolade Odetoyinbo was last updated on June 15, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.