Individual provider Active NPI

Radhakrishman Satheesan, MD

  • Pediatric Surgery Physician
  • Brooklyn, NY
National Provider Identifier
1023182649
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
233158 Issued in NY
Practice address
921 49TH St
Brooklyn, NY 11219-2923
Phone
(718) 283-8773
Fax
(718) 283-8796
NPI assigned
Nov 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Surgery Physician 2086S0120X 233158 NY Primary

Addresses

Primary practice location

921 49TH St
Brooklyn, NY 11219-2923

Mailing address

921 49TH St
Brooklyn, NY 11219-2923
Phone (718) 283-8773

Other identifiers 1

IdentifierTypeStateIssuer
02598507MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Medical Center Current Accepting new patients
Pediatric Surgery FPP Pediatric Surgery Past Accepting new patients

Locations

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

Interoperability endpoints

  • Direct secure messaging: radhakrishnansatheesan@mai.allscriptsdirect.net

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023182649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 49TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192923",
            "telephone_number": "718-283-8773",
            "fax_number": "718-283-8796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 49TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192923",
            "telephone_number": "718-283-8773",
            "fax_number": "718-283-8796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SATHEESAN",
        "first_name": "RADHAKRISHMAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "NY",
            "license": "233158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02598507",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.