Malavalli Seetharam, MD

Primary specialty

Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X

License

199169 Issued in NY

Practice address

1524 McHenry Ave
Suite 570
Modesto, CA 95350-4500

Phone

(209) 572-3880

Fax

(209) 572-3349

NPI assigned

Mar 6, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Malavalli Seetharam Professional name

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Valley Children's Medical Group

  • Pediatrics Physician
  • Modesto, CA
  • NPI 1437555265
  Medicare reassignment NPD
• Valley Children's Specialty Medical Group, Inc.

  • Pediatrics Physician
  • Madera, CA
  • NPI 1013968296
  Medicare reassignment NPD

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362009600000",
    "number": "1336279801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1524 MCHENRY AVE",
            "address_2": "SUITE 570",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504500",
            "telephone_number": "209-572-3880",
            "fax_number": "209-572-3349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 MCHENRY AVE",
            "address_2": "SUITE 570",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504500",
            "telephone_number": "209-572-3880",
            "fax_number": "209-572-3349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEETHARAM",
        "first_name": "MALAVALLI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2013-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "NY",
            "license": "199169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALAVALLI",
            "last_name": "SEETHARAM",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Niamh Mairin Seavy, MD
• Demetria Seawood
• Nicole Marie See, PMHNP-BC, APRN, RN
• Ekaterina D Seeba, FNP
• Nalae Seechan
• Samantha Ann Segars, MFT
• Marysol Segoviano Collazo
• Seirra Health Center (reproductive health care centre)
• Erica Sek
• Bavneet Kaur Sekhon

• Neurology with Special Qualifications in Child Neurology Physician in Modesto, CA
• Providers in Modesto, CA by specialty
• Neurology with Special Qualifications in Child Neurology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.