Individual provider Active NPI

Patabi Raj Seetharaman, M.D.

  • Ophthalmology Physician
  • Culver City, CA
National Provider Identifier
1467547364
Registry record updated Sep 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
35057803 Issued in OH
Practice address
4043 Irving PL Apt 109
Culver City, CA 90232-2964
Phone
(330) 998-3198
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X G166065 CA
Ophthalmology Physician 207W00000X 35057803 OH Primary

Addresses

Primary practice location

4043 Irving PL Apt 109
Culver City, CA 90232-2964

Mailing address

4043 Irving PL Apt 109
Culver City, CA 90232-2964
Phone (330) 998-3198

Other identifiers 1

IdentifierTypeStateIssuer
0897374MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20040429000807 OH Practitioner - Ophthalmology 0143217588 Receives reassigned benefits from 1 practitioner
Practice locations: Galion, OH; Cortland, OH; Cambridge, OH

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G166065CAMDOphthalmology Physician
35057803OHMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Patabi Raj Seetharaman MD Ophthalmology CurrentSince Jan 1, 1990 Accepting new patients
Safe Health Inc PastSince Jan 31, 2018 Accepting new patients
A R Srikantiah MD Inc Ophthalmology Past Accepting new patients
Diamond Optical Inc Past Accepting new patients
Raj Seetharaman MD Ophthalmology PastSince Jan 1, 1990 Accepting new patients
Mdreview LLC PastSince May 14, 2023 Accepting new patients

Locations

1930 Niles Cortland Rd NE
Warren, OH 44484
Phone (330) 392-4100

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Organizations & group practices 6

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695513600000",
    "number": "1467547364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4043 IRVING PL APT 109",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902322964",
            "telephone_number": "330-998-3198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4043 IRVING PL APT 109",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902322964",
            "telephone_number": "330-998-3198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEETHARAMAN",
        "first_name": "PATABI",
        "middle_name": "RAJ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2023-09-24",
        "certification_date": "2023-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G166065",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": "35057803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0897374",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Culver City, CA

Sources for this page

Verify at the official NPI Registry.