Individual provider Active NPI

Sujatha Sajeevan, M.D.

  • Family Medicine Physician
  • Cary, NC
National Provider Identifier
1447442983
Registry record updated Jun 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01871 Issued in NC
Practice address
519 Keisler Dr Ste 104
Cary, NC 27518-7098
Phone
(919) 233-8183
Fax
(919) 400-4365
NPI assigned
Aug 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01871 NC Primary

Addresses

Primary practice location

519 Keisler Dr Ste 104
Cary, NC 27518-7098

Mailing address

519 Keisler Dr Ste 104
Cary, NC 27518-7098
Phone (919) 233-8183

Other identifiers 1

IdentifierTypeStateIssuer
5914227MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20091112000026 NC Practitioner - Family PracticePractitioner - Emergency Medicine 4183762180 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

1135 Carthage St
Sanford, NC 27330-4162
Phone (919) 774-2100

2701 Pickett Rd
Durham, NC 27705-5688
Phone (919) 419-9600

519 Keisler Dr
Suite 104
Cary, NC 27518-7098
Phone (919) 233-8183

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Physician Services - Southeast Professional Corporation CurrentSince Sep 16, 2023 Accepting new patients
Spectrum Family Medicine PLLC Family Medicine CurrentSince Jun 1, 2017 Accepting new patients
Community Family Medicine and Obstetrics, P.a. Family Medicine Past Accepting new patients
Wake OBGYN P.a. PastSince Jun 2, 2017 Accepting new patients

Locations

519 Keisler Dr
Ste 104
Cary, NC 27518
Phone (919) 233-8183

288 S Ridgecrest Ave
Rutherfordton, NC 28139
Phone (252) 808-6000

1135 Carthage St
Sanford, NC 27330
Phone (910) 774-2100

Organizations & group practices 4

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": "1187308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622764800000",
    "number": "1447442983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 KEISLER DR STE 104",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275187098",
            "telephone_number": "919-233-8183",
            "fax_number": "919-400-4365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 KEISLER DR STE 104",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275187098",
            "telephone_number": "919-233-8183",
            "fax_number": "919-400-4365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAJEEVAN",
        "first_name": "SUJATHA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-17",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "01871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5914227",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

Verify at the official NPI Registry.