Active NPI
Sheela Deivanayagam, MD., DCH., MRCPCH
- Pediatric Gastroenterology Physician
- Indianapolis, IN
National Provider Identifier
1528187192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Gastroenterology Physician
- License
- 01069014A
- Practice address
- 8402 Harcourt Rd Ste 402
Indianapolis, IN 46260-2053 - Phone
- (317) 338-9450
- NPI assigned
- Mar 28, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 01069014A | IN | |
| Pediatric Gastroenterology Physician | 2080P0206X | 2001012033 | MO | |
| Pediatric Gastroenterology Physician | 2080P0206X | 01069014A | IN | Primary |
Addresses
Primary practice location
8402 Harcourt Rd Ste 402
Indianapolis, IN 46260-2053
Mailing address
8402 Harcourt Rd Ste 402
Indianapolis, IN 46260-2053
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036118394 | Medicaid | IL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | sheela.deivanayagam.1@7598.direct.athenahealth.com | St Vincent Pediatric Subspecialties |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01069014A | IN | MD | Pediatric Gastroenterology Physician |
| 2001012033 | MO | MD | Pediatric Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Vincent Pediatric Subspecialties | Pediatrics | Past | Accepting new patients |
| Major Hospital | Past | Accepting new patients |
Interoperability endpoints
- sheela.deivanayagam.1@7598.direct.athenahealth.com
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 and National Provider Directory roles.
-
- General Acute Care Hospital
- Shelbyville, IN
- NPI 1174555692
-
- Pediatrics Physician
- Indianapolis, IN
- NPI 1013967736
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655424000000",
"number": "1528187192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8402 HARCOURT RD STE 402",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462602053"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8402 HARCOURT RD STE 402",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462602053",
"telephone_number": "317-338-9450"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEIVANAYAGAM",
"first_name": "SHEELA",
"name_prefix": "Dr.",
"credential": "MD., DCH., MRCPCH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-28",
"last_updated": "2022-06-17",
"certification_date": "2022-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IN",
"license": "01069014A",
"primary": false
},
{
"code": "2080P0206X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Gastroenterology",
"state": "MO",
"license": "2001012033",
"primary": false
},
{
"code": "2080P0206X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Gastroenterology",
"state": "IN",
"license": "01069014A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036118394",
"state": "IL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "sheela.deivanayagam.1@7598.direct.athenahealth.com",
"affiliation": "Y",
"affiliationName": "St Vincent Pediatric Subspecialties",
"address_1": "8402 Harcourt Rd Ste 402",
"city": "Indianapolis",
"state": "IN",
"country_code": "US",
"postal_code": "462602053",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.