Individual provider Active NPI

Deepa Soundara Rajan

  • Pediatrics Physician
  • Detroit, MI
National Provider Identifier
1215118625
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301089492 Issued in MI
Practice address
3901 Beaubien St
2ND Floor
Detroit, MI 48201-2119
Phone
(313) 745-4000
NPI assigned
Nov 14, 2007
Last updated
Jun 17, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301089492 MI Primary

Addresses

Primary practice location

3901 Beaubien St
2ND Floor
Detroit, MI 48201-2119

Mailing address

3737 Beaubien St
Apt #704
Detroit, MI 48201-2152

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address upmchospitals@upmcdirect.com UPMC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130529000526 PA Practitioner - Pediatric MedicinePractitioner - Neurology 4880832047 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
80.94 of 100Reported as group
Quality
61.89
Promoting interoperability
100
Improvement activities
40
Cost
74.58

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301089492MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Pittsburgh Physicians Pediatrics CurrentSince Jul 1, 2013 Accepting new patients
University of Pittsburgh Physicians CurrentSince Jul 1, 2013 Accepting new patients
University of Pittsburgh Physicians Current Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

2 Hot Metal St
#One
Pittsburgh, PA 15203
Phone (412) 432-5864

4401 Penn Ave
Pittsburgh, PA 15224
Phone (412) 692-5030

519 Penn Ave
Ste 206
Turtle Creek, PA 15145
Phone (412) 823-3121

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1215118625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 BEAUBIEN ST",
            "address_2": "APT #704",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 BEAUBIEN ST",
            "address_2": "2ND FLOOR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012119",
            "telephone_number": "313-745-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUNDARA RAJAN",
        "first_name": "DEEPA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-14",
        "last_updated": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301089492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "upmchospitals@upmcdirect.com",
            "affiliation": "Y",
            "affiliationName": "UPMC",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.