GABRIEL BOLADELE ROSANWO (MD) – Family Medicine Physician, NPI 1598740466
Family Medicine Physician
Main info
Contacts
Profile Insights
NPPES metrics only — not quality of care.
Loading map...
Provider Addresses for GABRIEL BOLADELE ROSANWO (MD)
County Road, Troy, Wallowa County, Oregon, United States
SUITE 103
TROY, OH 453731337
Phone: (937) 773-0428
Fax: (937) 773-0439
Type: Mailing
17 RAINIER CIR
SOUTH BARRINGTON, IL 600109440
Phone: (630) 337-4445
Type: Mailing
1270 E State Road 205 Ste 140
Columbia City, IN 467258505
Phone: (260) 248-9090
Type: Location
642 W Hospital Rd
Paoli, IN 474549672
Phone: (812) 723-7450
Type: Location
3119 WOODMAN DRIVE
PREVEA HEALTH
ALTOONA, WI 547202668
Phone: (920) 496-4700
Type: Location
10400 HALIGUS RD
HUNTLEY, IL 601429553
Phone: (815) 356-2323
Fax: (847) 802-7201
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-10-18
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 4 Medicare enrollment records; no due dates published yet.
Enrollment records
4
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20051115000723 | I | Obstetrics/Gynecology | IL | TBD |
| I20150903002482 | I | Obstetrics/Gynecology | MI | TBD |
| I20180426000115 | I | Obstetrics/Gynecology | IN | TBD |
| I20191018001377 | I | Obstetrics/Gynecology | TX | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 45373)
Loading plans...
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.