Active NPI
Seetharaman Adimoolam, M.D., P.C.
- Specialist
- Staten Island, NY
National Provider Identifier
1447336755
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- NYS 121313
- Practice address
- 1756 Richmond Ave
Staten Island, NY 10314-3902 - Phone
- (718) 494-3383
- Fax
- (718) 494-1705
- NPI assigned
- Oct 29, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | NYS 121313 | NY | Primary |
Addresses
Primary practice location
1756 Richmond Ave
Staten Island, NY 10314-3902
Mailing address
1756 Richmond Ave
Staten Island, NY 10314-3902
Phone (718) 494-3383
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 25A411 | Other | NY | EMPIRE BC/BS |
| OC1723 | Other | NY | HEALTHNET |
| OS053 | Other | NY | OXFORD HEALTH PLANS |
| 0019584 | Other | NY | GHI |
| 252780301 | Other | NY | HEALTH PLUS |
| 25A413 | Other | NY | EMPIRE BC/BS |
| 00440597 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NYS 121313 | NY | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| NYU Lutheran Medical Center | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Brooklyn, NY
- NPI 1538111653
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162080000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1447336755",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1756 RICHMOND AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103143902",
"telephone_number": "718-494-3383",
"fax_number": "718-494-1705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1756 RICHMOND AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103143902",
"telephone_number": "718-494-3383",
"fax_number": "718-494-1705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADIMOOLAM",
"first_name": "SEETHARAMAN",
"credential": "M.D., P.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": "NYS 121313",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE BC/BS",
"identifier": "25A411",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET",
"identifier": "OC1723",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD HEALTH PLANS",
"identifier": "OS053",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI",
"identifier": "0019584",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PLUS",
"identifier": "252780301",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE BC/BS",
"identifier": "25A413",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00440597",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.