Individual provider Active NPI

Abirami Rajasegaran

  • Diagnostic Radiology Physician
  • Portland, OR
National Provider Identifier
1396331856
Registry record updated Jun 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
PG204899 Issued in OR
Practice address
3181 SW Sam Jackson Park Rd # L-579
Portland, OR 97239-3011
Phone
(925) 588-5722
NPI assigned
Dec 17, 2020
Last updated
Jun 26, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X PG204899 OR Primary

Addresses

Primary practice location

3181 SW Sam Jackson Park Rd # L-579
Portland, OR 97239-3011

Mailing address

3181 SW Sam Jackson Park Rd # L-579
Portland, OR 97239-3011
Phone (925) 588-5722

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20260528003556 OR Practitioner - Diagnostic Radiology 4284039520 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Texas Tech University Health Science Center School of Medicine, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

364 SE 45TH Ave
Portland, OR 97215-1016

415 Crosslake Dr
Suite C
Evansville, IN 47715-8263

4783 Drift Creek Rd SE
Sublimity, OR 97385-9671

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 2

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": "1608163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656201600000",
    "number": "1396331856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD # L-579",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "925-588-5722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD # L-579",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "925-588-5722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJASEGARAN",
        "first_name": "ABIRAMI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-17",
        "last_updated": "2022-06-26",
        "certification_date": "2022-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OR",
            "license": "PG204899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.