NPIMap

Organization Active NPI

Seshadri Raju, M.D., PA.

  • Vascular Surgery Physician
  • Jackson, MS
National Provider Identifier
1174556377
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
06665 Issued in MS
Legal business name
SESHADRI RAJU, M.D., PA.
Practice address
971 Lakeland Dr Ste 401
Jackson, MS 39216
Phone
(601) 939-4230
Fax
(601) 664-6694
NPI assigned
Jul 9, 2006
Last updated
Jun 11, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Authorized official

Name
Mrs. Sarah Lynn Guinn
Title
Billing Manager
Phone
(601) 939-4230

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 06665 MS Primary

Addresses

Primary practice location

971 Lakeland Dr Ste 401
Jackson, MS 39216

Mailing address

971 Lakeland Dr Ste 401
Jackson, MS 39216-4607
Phone (601) 939-4230

Other identifiers 1

IdentifierTypeStateIssuer
09014607MedicaidMS

Other names 1

  • The Rane Center Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080620000344 MS Part B Supplier - Clinic/Group Practice 3971674896 Receives reassigned benefits from 14 practitioners
Practice locations: Jackson, MS

National Provider Directory

National Provider Directory

Locations

971 Lakeland Dr
Ste 401
Jackson, MS 39216
Phone (601) 939-4230

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1174556377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "971 LAKELAND DR STE 401",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164607",
            "telephone_number": "601-939-4230",
            "fax_number": "601-939-5210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "971 LAKELAND DR STE 401",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39216",
            "telephone_number": "601-939-4230",
            "fax_number": "601-664-6694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SESHADRI RAJU, M.D., PA.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "GUINN",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "601-939-4230",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MS",
            "license": "06665",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09014607",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Rane Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.