NPIMap

Individual provider Active NPI

Devaki Sundararajan, D.M.D

  • Oral and Maxillofacial Pathology Dentistry
  • Boston, MA
National Provider Identifier
1275708455
Registry record updated Apr 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
License
9873 Issued in MA
Practice address
100 E Newton St # G04
Oral Pathology Department
Boston, MA 02118-2308
Phone
(617) 638-4775
Fax
(617) 638-4697
NPI assigned
Apr 28, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Pathology Dentistry 1223P0106X 9873 MA Primary

Addresses

Primary practice location

100 E Newton St # G04
Oral Pathology Department
Boston, MA 02118-2308

Mailing address

100 E Newton St # G04
Oral Pathology Department
Boston, MA 02118-2308
Phone (617) 638-4775

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20221027002562 MA Practitioner - Dentist 9032586474 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Boston Univ Goldman School of Dental Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trustees of Boston UniversityGroup PAC ID 8921070822, 43 clinicians

Practice addresses (Care Compare)

100 E Newton St
G407
Boston, MA 02118-3552
Phone (617) 638-4350

Hospital & facility affiliations

  • Boston Medical Center Hospital, Boston, MA, CCN 220031

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9873MAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Medical Center Corporation Current Accepting new patients
Trustees of Boston University Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: dsundararajan115325@direct.bmc.masshiway.net

Organizations & group practices 3

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 8

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": "1209340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209340800000",
    "number": "1275708455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E NEWTON ST # G04",
            "address_2": "ORAL PATHOLOGY DEPARTMENT",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182308",
            "telephone_number": "617-638-4775",
            "fax_number": "617-638-4697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E NEWTON ST # G04",
            "address_2": "ORAL PATHOLOGY DEPARTMENT",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182308",
            "telephone_number": "617-638-4775",
            "fax_number": "617-638-4697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDARARAJAN",
        "first_name": "DEVAKI",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-28",
        "last_updated": "2008-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "MA",
            "license": "9873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.