Individual provider Active NPI

Sandra Rajan, OD

  • Optometrist
  • Sugar Land, TX
National Provider Identifier
1427544006
Registry record updated Jun 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9458TG Issued in TX
Practice address
11555 University Blvd
Sugar Land, TX 77478-3889
Phone
(713) 442-9100
NPI assigned
Jul 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9458TG TX Primary

Addresses

Primary practice location

11555 University Blvd
Sugar Land, TX 77478-3889

Mailing address

11511 Shadow Creek Pkwy
Pearland, TX 77584-7298
Phone (713) 442-0000

Other practice location 1

1010 S Ponds Dr
Webster, TX 77598-1409
Phone (713) 442-4300

Other identifiers 3

IdentifierTypeStateIssuer
396117902MedicaidTX
396117903MedicaidTX
396117904MedicaidTX

Electronic endpoints 4

TypeEndpointUseAffiliation
Direct Messaging Address srajan35035@direct.kelsey-seybold.com Direct
FHIR URL https://ssrx.ksnet.com/FhirProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)
Direct Messaging Address srajan35035@direct.kelsey-seybold.com Direct
FHIR URL https://ssrx.ksnet.com/FhirProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180815002618 TX Practitioner - Optometry 5799034336 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kelsey-Seybold Medical Group, PLLCGroup PAC ID 9739093527, 941 clinicians

Practice addresses (Care Compare)

11555 University Blvd
Sugar Land, TX 77478-3889
Phone (713) 442-9100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9458TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Houston System CurrentSince Aug 1, 2018 Accepting new patients
Kelsey-Seybold Medical Group, PLLC CurrentSince Jan 18, 2021 Accepting new patients
University of Houston CurrentSince Aug 1, 2018 Accepting new patients
Albuquerque Indian Health Center CurrentSince Dec 25, 2019 Accepting new patients

Locations

801 Vassar Dr NE
Albuquerque, NM 87106
Phone (505) 248-4000

190 Heights Blvd
Houston, TX 77007
Phone (713) 527-8480

2727 W Holcombe Blvd
Houston, TX 77025
Phone (713) 790-9412

4401 Martin Luther King Blvd
Houston, TX 77204
Phone (713) 743-1921

4901 Calhoun Rd
Rm 2107
Houston, TX 77204
Phone (713) 743-1921

7010 Highway 6
Missouri City, TX 77459
Phone (713) 442-4200

11511 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 442-4997

2515 Business Center Dr
Pearland, TX 77584
Phone (713) 442-7200

11555 University Blvd
Sugar Land, TX 77478
Phone (713) 442-9100

1010 S Ponds Dr
Webster, TX 77598
Phone (713) 442-4300

Interoperability endpoints

  • Direct secure messaging: srajan35035@direct.kelsey-seybold.com

Organizations & group practices 5

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": "1530835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1427544006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11511 SHADOW CREEK PKWY",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847298",
            "telephone_number": "713-442-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11555 UNIVERSITY BLVD",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774783889",
            "telephone_number": "713-442-9100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1010 S Ponds Dr",
            "address_purpose": "LOCATION",
            "city": "Webster",
            "state": "TX",
            "postal_code": "775981409",
            "country_code": "US",
            "telephone_number": "713-442-4300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAJAN",
        "first_name": "SANDRA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-06",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9458TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "396117902",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "396117903",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "396117904",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "srajan35035@direct.kelsey-seybold.com",
            "affiliation": "N",
            "endpointDescription": "digital contact information",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1010 S Ponds Dr",
            "city": "Webster",
            "state": "TX",
            "country_code": "US",
            "postal_code": "775981409",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://ssrx.ksnet.com/FhirProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR endpoint URL",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1010 S Ponds Dr",
            "city": "Webster",
            "state": "TX",
            "country_code": "US",
            "postal_code": "775981409",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "srajan35035@direct.kelsey-seybold.com",
            "affiliation": "N",
            "endpointDescription": "digital contact information",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "11555 University Blvd",
            "city": "Sugar Land",
            "state": "TX",
            "country_code": "US",
            "postal_code": "774783889",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://ssrx.ksnet.com/FhirProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR endpoint URL",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "11555 University Blvd",
            "city": "Sugar Land",
            "state": "TX",
            "country_code": "US",
            "postal_code": "774783889",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

Verify at the official NPI Registry.