Individual provider Active NPI

Reginald Sequeira, M.D.

  • Cardiovascular Disease Physician
  • Kettering, OH
National Provider Identifier
1215933387
Registry record updated Nov 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
35069268S Issued in OH
Practice address
540 Lincoln Park Blvd
Suite 200
Kettering, OH 45429-6401
Phone
(937) 298-8058
Fax
(937) 298-5638
NPI assigned
Jun 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 35069268S OH Primary

Addresses

Primary practice location

540 Lincoln Park Blvd
Suite 200
Kettering, OH 45429-6401

Mailing address

540 Lincoln Park Blvd Ste 200
Dayton, OH 45429-6403
Phone (937) 298-8058

Other identifiers 1

IdentifierTypeStateIssuer
2201674MedicaidOH

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address rsequeira194645@direct.ketteringhealth.org
FHIR URL https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20040319000301 OH Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Nuclear Medicine 3274423413 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Nuclear Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kettering Independent Medical Group IncGroup PAC ID 3173710936, 699 clinicians

Practice addresses (Care Compare)

1141 N Monroe Dr
Xenia, OH 45385-1619
Phone (937) 490-2270

1380 E Stroop Rd
Kettering, OH 45429-4926
Phone (937) 293-3486

2510 Commons Blvd
Suite 125
Beavercreek, OH 45431-3835
Phone (937) 454-9527

3535 Pentagon Blvd
Beavercreek, OH 45431-1705

3535 Pentagon Park Blvd
Suite 400
Dayton, OH 45431-1705
Phone (937) 490-2264

3535 Southern Blvd
Kettering, OH 45429-1221
Phone (937) 395-8646

4000 Miamisburg Centerville Rd
Miamisburg, OH 45342-7615

4160 Little York Rd
Suite 20
Dayton, OH 45414-5803
Phone (937) 454-9527

4403 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 433-5309

4441 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 298-7751

450 B Washington Jackson Rd
Eaton, OH 45320-7601

450 Washington Jackson Rd
Suite 110
Eaton, OH 45320-7601
Phone (937) 454-9527

540 Lincoln Park Blvd
Suite 200
Dayton, OH 45429-6403
Phone (937) 298-8058

600 W Main St
Troy, OH 45373-3384

7677 Yankee St
Suite 140
Dayton, OH 45459-3475
Phone (866) 224-9472

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.34 of 100Reported as group
Quality
63.67
Promoting interoperability
100
Improvement activities
40
Cost
74.14

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35069268SOHMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kettering Independent Medical Group Inc Cardiovascular Disease CurrentSince Dec 29, 2022 Accepting new patients
Premier Heart Associates, Inc Cardiovascular Disease Past Accepting new patients
Professional Readers Group, Inc Past Accepting new patients
Non-Invasive Interpretations Cardiovascular Disease Past Accepting new patients
Non-Invasive Interpretations LLC Cardiovascular Disease Past Accepting new patients
Dayton Cardiac Electrophysiology Associates, Inc. Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Sinnathamby Cardiology Services, Inc. Cardiovascular Disease PastSince Dec 5, 2014 Accepting new patients

Locations

3535 Pentagon Blvd
Ste 320
Beavercreek, OH 45431
Phone (937) 490-2270

3535 Pentagon Blvd
Ste 330
Beavercreek, OH 45431
Phone (937) 558-3021

3535 Pentagon Blvd
Ste 220
Beavercreek, OH 45431
Phone (937) 429-7350

450B Washington Jackson Rd
Eaton, OH 45320
Phone (937) 226-7880

540 Lincoln Park Blvd
Ste 200
Kettering, OH 45429
Phone (937) 293-1117

4403 Far Hills Ave
Kettering, OH 45429
Phone (937) 395-3910

4000 Miamisburg Centerville Rd
Ste 100
Miamisburg, OH 45342
Phone (937) 643-9939

1 Prestige Pl
Ste 550
Miamisburg, OH 45342
Phone (937) 752-2306

825 N Main St
Ste 230
Springboro, OH 45066
Phone (866) 224-9472

1141 N Monroe Dr
Fl 3
Xenia, OH 45385
Phone (937) 372-3638

Organizations & group practices 8

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.

Hospital & facility affiliations 5

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": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606089600000",
    "number": "1215933387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 LINCOLN PARK BLVD STE 200",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454296403",
            "telephone_number": "937-298-8058",
            "fax_number": "937-298-5638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 LINCOLN PARK BLVD",
            "address_2": "SUITE 200",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454296401",
            "telephone_number": "937-298-8058",
            "fax_number": "937-298-5638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEQUEIRA",
        "first_name": "REGINALD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "35069268S",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2201674",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rsequeira194645@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "540 Lincoln Park Blvd",
            "address_2": "Suite 200",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454296401",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "540 Lincoln Park Blvd",
            "address_2": "Suite 200",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454296401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kettering, OH

Sources for this page

Verify at the official NPI Registry.