Individual provider Active NPI

Sandhya Seetharam, M.D.,

  • Internal Medicine Physician
  • Frisco, TX
National Provider Identifier
1366638181
Registry record updated Nov 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C146553 Issued in CA
Practice address
11173 Villa Canales LN
Frisco, TX 75035
Phone
(312) 315-2257
NPI assigned
Sep 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X C146553 CA Primary

Addresses

Primary practice location

11173 Villa Canales LN
Frisco, TX 75035

Mailing address

802 Station Blvd
Aurora, IL 60504-2033
Phone (312) 315-2257

Other practice location 1

802 Station Blvd
Aurora, IL 60504-2033
Phone (312) 315-2257

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170811001587 CA Practitioner - Internal Medicine 3971680182 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C146553CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Clara CurrentSince Jun 10, 2017 Accepting new patients
County of Santa Clara Current Accepting new patients
County of Santa Clara Internal Medicine CurrentSince Jun 10, 2017 Accepting new patients

Locations

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

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.

NPI Registry JSON

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

{
    "created_epoch": "1189900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572998400000",
    "number": "1366638181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 STATION BLVD",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605042033",
            "telephone_number": "312-315-2257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11173 VILLA CANALES LN",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "75035",
            "telephone_number": "312-315-2257"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "802 Station Blvd",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "IL",
            "postal_code": "605042033",
            "country_code": "US",
            "telephone_number": "312-315-2257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEETHARAM",
        "first_name": "SANDHYA",
        "name_prefix": "Dr.",
        "credential": "M.D.,",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-16",
        "last_updated": "2019-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C146553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

Verify at the official NPI Registry.