NPIMap

Individual provider Active NPI

Pradeep Kumar Selvaraj, M.D

  • Internal Medicine Physician
  • Woodville, MS
National Provider Identifier
1053545913
Registry record updated May 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
22109 Issued in MS
Practice address
451 Bank St
Woodville, MS 39669-6000
Phone
(601) 888-3421
Fax
(601) 888-3685
NPI assigned
May 7, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 22109 MS Primary

Addresses

Primary practice location

451 Bank St
Woodville, MS 39669-6000

Mailing address

178 Highway 24 E
Centreville, MS 39631-4171
Phone (601) 890-0500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120829000192 MS Practitioner - Internal Medicine 4880841709 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Field Memorial Community HospitalGroup PAC ID 0547248544, shared by 7 NPIs, 41 clinicians

Practice addresses (Care Compare)

451 Bank St
Woodville, MS 39664-0876
Phone (601) 888-3421

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22109MSMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Field Memorial Community Hospital CurrentSince Oct 1, 2025 Accepting new patients
Field Memorial Community Hospital Internal Medicine CurrentSince Aug 2, 2012 Accepting new patients
Field Memorial Community Hospital CurrentSince Aug 2, 2012 Accepting new patients
Field Memorial Community Hospital Current Accepting new patients
Field Memorial Community Hospital Past Accepting new patients

Locations

270 E Main St
Centreville, MS 39631
Phone 6016455221335

178 Highway 24 E
Ste B
Centreville, MS 39631
Phone (601) 835-0077

178 Highway 24 E
Centreville, MS 39631
Phone (601) 890-0500

260 W Main St
Centreville, MS 39631
Phone (601) 645-5088

178 Highway 24 E
Ste A
Centreville, MS 39631
Phone (601) 645-5361

434 N Captain Gloster Dr
Gloster, MS 39638
Phone (601) 225-4711

451 Bank St
Woodville, MS 39669
Phone (601) 888-3421

Organizations & group practices 5

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

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1241654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777852800000",
    "number": "1053545913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "178 HIGHWAY 24 E",
            "city": "CENTREVILLE",
            "state": "MS",
            "postal_code": "396314171",
            "telephone_number": "601-890-0500",
            "fax_number": "601-888-3685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 BANK ST",
            "city": "WOODVILLE",
            "state": "MS",
            "postal_code": "396696000",
            "telephone_number": "601-888-3421",
            "fax_number": "601-888-3685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELVARAJ",
        "first_name": "PRADEEP",
        "middle_name": "KUMAR",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-07",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "22109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodville, MS

Sources for this page

Verify at the official NPI Registry.