Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1457932014 Individual Practitioner Female Practitioner

Dr. Mofesola Modupe , DO

Pediatrics • Augusta, ME

Professional Overview & Biography Verified Profile Summary

Dr. Mofesola Modupe, DO is a registered healthcare professional specializing in Pediatrics in Augusta, ME. Practice services are available at 6 E CHESTNUT ST STE 310 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

6 E Chestnut St Ste 310

Augusta, ME 043305760

Telephone 2076232977
Fax 2076269374
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Augusta, ME

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 21.7 Yrs
Regional Practice Density
11 Specialists

Practicing in Augusta, ME (319 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-07-22
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License ME DO4361

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Secondary Practice Locations

530 Ne Glen Oak Ave

Peoria, IL 616370001

Phone: 3096652274

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

11 Associated Practitioners
Jennifer Blossom , MS

Psychologist - Clinical Child & Adolescent

NPI 1063947299

Master of Science

Dr. Stefanie Lewis , DO

Family Medicine - Sports Medicine

NPI 1104289990

Doctor of Osteopathic Medicine (D.O.)

NPI 1154390268

Doctor of Medicine (M.D.)

Theresa Bloom , CPNP-PC

Nurse Practitioner - Pediatrics

NPI 1396611406

CPNPPC

NPI 1417923947

Doctor of Medicine (M.D.)

NPI 1437123197

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location July 22, 2026

Registered at 6 E CHESTNUT ST STE 310, AUGUSTA, ME 043305760 (Tel: 2076232977)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 22, 2026

Pediatrics (License #DO4361 in ME)

NPI Profile Active April 15, 2021

NPI status registered as active in NPPES database

📍
Updated Practice Location April 15, 2021

Registered at 530 NE GLEN OAK AVE, PEORIA, IL 616370001 (Tel: 3096652274)

📍
Updated Business Mailing Address April 15, 2021

Registered at 530 NE GLEN OAK AVE, PEORIA, IL 616370001

👤
Provider Name / Credentials Updated April 15, 2021

Recorded as MOFESOLA MODUPE, DO

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 15, 2021

Student in an Organized Health Care Education/Training Program (License #90200000X in None)

🟢
Initial NPI Registration & Enumeration April 15, 2021

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1457932014
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 15, 2021
Last Update: July 22, 2026
Sole Proprietor: No

Mailing Address

530 Ne Glen Oak Ave

Peoria, IL 616370001

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.